[One year's experience with mechanical ventilation in newborn infants (author's transl)]
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Artificial ventilation is crucial for low birth weight infants (LBWI) with severe Hyalin Membrane Syndrome (HMS). Quality obstetrical care significantly impacts LBWI survival rates in neonatal intensive care.
Area of Science:
- Neonatal intensive care
- Pediatric respiratory medicine
- Perinatal outcomes
Context:
- Analysis of 80 artificial ventilation cases in the first year of neonatal intensive care.
- 62 cases involved Low Birth Weight Infants (LBWI), with 12% requiring mechanical ventilation.
- Focus on outcomes of ventilated infants, particularly those with Hyalin Membrane Syndrome (HMS).
Purpose:
- To evaluate the outcomes of artificial ventilation in newborns, especially LBWI.
- To assess the incidence of complications like intraventricular hemorrhage, HMS, bronchopulmonary dysplasia, and pneumothorax.
- To compare mortality rates of LBWI based on place of delivery and highlight the importance of obstetrical care quality.
Summary:
- 53 ventilated infants had severe HMS; 17 survived, while 36 died from intraventricular hemorrhage or HMS.
- Bronchopulmonary Dysplasia occurred in all patients ventilated >7 days; 5 cases of pneumothorax were noted.
- Respiratory insufficiency apart from HMS showed better outcomes (12/15 survivors).
Impact:
- Highlights the critical role of neonatal intensive care and mechanical ventilation for LBWI with respiratory distress.
- Demonstrates a significantly higher mortality rate (34%) for LBWI delivered at home compared to hospital births (9.9%).
- Emphasizes that the quality of obstetrical care is a key determinant for successful newborn intensive care outcomes.
Abstract:
During the first year of newborn intensive care at the Landeskinderkrankenhaus Linz/Donau there were 80 cases of artificial ventilation, 62 of these were Low Birth Weight Infants (LBWI). 12% of all LBWI required mechanical ventilation. 53 ventilated infants suffered from severe Hyalin Membrane Syndrome (HMS). 17 survived, 18 died of intraventricular hemorrhage and 18 died of HMS. Bronchopulmonary Dysplasia was found in all patients ventilated for more than 7 days. 5 cases of pneumothorax occurred during ventilation. Good results were obtained in cases of respiratory insufficiency other than HMS (15 cases, 12 survivors. Mortality rate of LBWI delivered in Hospitals was 9.9%, whereas 34% of the LBWI delivered at home but cared for under identical conditions in the nursery died. This difference offers good evidence for the importance of the quality of the obstetrical care for the results of newborn intensive care.