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[Complications and survival rate in preterm infants and neonates treated with mechanical ventilation (author's
Insights
Mechanical ventilation improved survival rates for preterm infants and neonates from 21.2% to 43% between 1972-1976. Survival varied by respiratory failure cause, with pulmonary disease showing the best outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Respiratory Physiology
Context:
- Mechanical ventilation is a critical intervention for preterm infants and neonates experiencing respiratory failure.
- Understanding the indications and outcomes associated with mechanical ventilation is crucial for improving patient care.
- This study analyzes data from a cohort of 201 infants treated between 1972 and 1976.
Purpose:
- To evaluate the survival rates and complication profiles of preterm infants and neonates undergoing mechanical ventilation.
- To identify factors influencing survival, including the underlying cause of respiratory failure.
- To assess trends in survival over time.
Summary:
- A total of 201 infants received mechanical ventilation for various causes of respiratory failure (pulmonary, cerebral, cardiac, shock, mechanical).
- Bronchopulmonary complications, particularly infections and air leaks, were common. Extrapulmonary complications included seizures, hemorrhages, and septicemia.
- Overall survival increased significantly from 21.2% (1972-1973) to 43% (1974-1976). Survival rates varied by indication group, with pulmonary disease (P-group) and cerebral disturbance (Z-group) showing better outcomes than cardiac disease (C-group) and shock (SCH-group).
Impact:
- The study highlights a significant improvement in survival rates for neonates requiring mechanical ventilation over a five-year period.
- Identifying specific indications associated with higher mortality can inform targeted treatment strategies and resource allocation.
- Findings underscore the importance of managing bronchopulmonary and extrapulmonary complications to further enhance outcomes in this vulnerable population.
Abstract:
Between January 1972 and December 1976 201 preterm infants and neonates were treated with mechanical ventilation. These children were classified into 6 groups according to the indications for mechanical ventilation: P = respiratory failure caused by pulmonary disease; Z-P = respiratory failure caused by cerebral disturbance with simultaneous respiratory disease; Z = respiratory failure caused by cerebral disturbance; C = respiratory failure caused by cardiac disease; SCH = respiratory failure through shock; M = respiratory failure caused by mechanical disturbance; Bronchopulmonary complications developed in 70% of the survivors and in 60% of the fatalities. The most serious bronchopulmonary complications were infections which occured with similar frequency in all indication groups as late-onset complications, and air-leaks which occured as early complications. The latter complication was significantly higher (38%) in the first than in the other groups. The most serious extrapulmonary complications were seizures, intracerebral hemorrhages and septicemia. 71 of the 201 patients survived. There was a significant increase in the survival rate from 21.2% in 1972-1973 to 43% in 1974-1976. The survival rates differed significantly within the indication groups. The best result was found in the p-group followed by the Z-group. The highest mortality rate was found in the SCH and C-group.