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Published on: January 18, 2011
Assisted ventilation for hyaline membrane disease
M Singh1, A K Deorari, R Aggarwal
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
Assisted ventilation for neonates with hyaline membrane disease (HMD) shows improved survival rates. However, nosocomial infections remain a significant complication requiring ongoing attention.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Respiratory Physiology
Background:
- Hyaline membrane disease (HMD) is a common respiratory distress in premature infants.
- Assisted ventilation is crucial for managing HMD but carries risks.
Purpose of the Study:
- To evaluate the outcomes and complications of assisted ventilation in neonates with HMD.
- To assess trends in survival rates and identify major complications.
Main Methods:
- Retrospective, hospital-based study.
- Analysis of 75 premature neonates with HMD requiring assisted ventilation over five years.
- Key outcome measures included survival rates and ventilation-associated complications.
Main Results:
- Survival rates improved significantly from 22.2% to 77.8% during the study period.
- Lower survival observed in infants with lower birth weight and shorter gestation.
- Intraventricular hemorrhage (52%) and nosocomial infections (50.6%) were leading causes of mortality and morbidity.
Conclusions:
- Assisted ventilation for HMD in neonates has demonstrated improved outcomes over time.
- Nosocomial infections represent a persistent and significant challenge in ventilated neonates.
Objectives:
To study the outcome and complications of assisted ventilation in neonates with hyaline membrane disease (HMD).
Design:
Retrospective study.
Setting:
Hospital based.
Subjects:
Seventy five premature neonates with HMD needing assisted ventilation born over a period of five years.
Main Outcome Measures:
Survival rate among those ventilated and complications of assisted ventilation.
Results:
Survival on assisted ventilation improved from initial 22.2% in 1989 to 77.8% in 1993. Of 19 babies weighing between 750-1000 g, 8(42.1%) survived. Twelve of 27 babies (44.4%) with a gestation of less than 28 weeks survived. Survival rates in babies with gestation of more than 33 weeks was 94%. Intraventricular hemorrhage was the leading cause of death in 52% babies. Nosocomial infections were common and occurred in 50.6% of infants on ventilation and accounted for one-third of deaths. Pneumothorax occurred in one-fifth of babies and was responsible for 3 deaths. Pulmonary interstitial emphysems was observed in 6 babies. Six babies developed bronchopulmonary dysplasia while 7 had retinopathy of prematurity.
Conclusions:
Outcome of neonates needing assisted ventilation for HMD has shown consistent improvement over the period of study. Nosocomial infections continue to be a major complication of assisted ventilation in neonates.
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