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[Ventilator treatment at a subregional neonatal unit. Experiences form the Vestfold central hospital 1989-1994]
During the six-year period 1989-94, 106 infants were treated with mechanical ventilation at the neonatal unit, Vestfold Central Hospital, Tønsberg, Norway (0.8% of live born infants). A total of 114 treatments were started. Indications were respiratory distress syndrome (RDS) in 63 (55%) of the treatments, asphyxia in 21 (18%), septicaemia/pneumonia in 12 (11%), congenital malformations in 8 (7%) and other indications in 10 (9%). 56 (49%) of the treatments lasted less than 24 hours until extubation or transportation to a regional hospital. The mean duration of treatment was 42.2 hours (range 0.7-183 hours). Pneumothorax occurred in seven infants (7%), in six of these during resuscitation and stabilizing treatment before mechanical ventilation. 16 infants (15%) died (cumulated mortality). Of the 90 surviving infants, nine (10%) acquired brain damage. The local ventilator treatment programme reduced the need of postnatal transports in infants with RDS by 65% during the period 1989-94 (1.2 per 1000 live born infants) compared with the period 1982-88 (3.4 per 1000) (p < 0.01). Ventilator treatment programmes for newborn infants can be undertaken safely at a subregional neonatal unit. The incidence of postnatal transports to a regional hospital is reduced.
During the six-year period 1989-94, 106 infants were treated with mechanical ventilation at the neonatal unit, Vestfold Central Hospital, Tønsberg, Norway (0.8% of live born infants). A total of 114 treatments were started. Indications were respiratory distress syndrome (RDS) in 63 (55%) of the treatments, asphyxia in 21 (18%), septicaemia/pneumonia in 12 (11%), congenital malformations in 8 (7%) and other indications in 10 (9%). 56 (49%) of the treatments lasted less than 24 hours until extubation or transportation to a regional hospital. The mean duration of treatment was 42.2 hours (range 0.7-183 hours). Pneumothorax occurred in seven infants (7%), in six of these during resuscitation and stabilizing treatment before mechanical ventilation. 16 infants (15%) died (cumulated mortality). Of the 90 surviving infants, nine (10%) acquired brain damage. The local ventilator treatment programme reduced the need of postnatal transports in infants with RDS by 65% during the period 1989-94 (1.2 per 1000 live born infants) compared with the period 1982-88 (3.4 per 1000) (p < 0.01). Ventilator treatment programmes for newborn infants can be undertaken safely at a subregional neonatal unit. The incidence of postnatal transports to a regional hospital is reduced.