Mechanical ventilation in newborn infants

A 20-month experience of mechanical ventilation (MV) in the newborn infants (birth weight greater than or equal to 1500 g) from a developing country is described. A total of 41 neonates (4.1% of total admissions to the Neonatal Intensive Care Unit) were treated with MV. The mode of MV was intermittent positive pressure ventilation and continuous positive airway pressure via nasotracheal intubation. The mean birth weight and gestational age were 2544 g and 36.2 weeks, respectively. The mean age at the start of MV was 141 h and the mean duration was 54 h. The indications for MV were respiratory distress syndrome (18), aspiration pneumonia (8), non-aspiration pneumonia (6), apnoea (8) and tetanus neonatorum (1). The complications encountered during MV were sepsis (26.8%), pulmonary haemorrhage (21.9%), congestive heart failure (17.1%), pneumothorax (14.6%) and intraventricular haemorrhage (7.3%). Post-extubation atelectasis was observed in 29.6% of cases. The overall survival rate was 43.9%. The risk factors for a poor outcome were birth weight less than 2000 g, prematurity and late referrals to the Neonatal Intensive Care Unit.