scholarly journals Clinical Profile and Outcome of Mechanically Ventilated Neonates in a Tertiary Level Hospital

2016 ◽  
Vol 35 (3) ◽  
pp. 218-223
Author(s):  
Prabina Shrestha ◽  
Srijana Basnet ◽  
Laxman Shrestha
Keyword(s):  
Mechanical Ventilation ◽  
Survival Rate ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Major Complication ◽  
Meconium Aspiration Syndrome ◽  
University Teaching ◽  
Severe Respiratory Distress ◽  
Disease Pattern ◽  
Hospital Acquired

Introduction: Many sick neonates admitted to neonatal intensive care unit (NICU) require mechanical ventilation but it is associated with various complications and the outcome of neonates is unpredictable. This study aims to identify the indications for mechanical ventilation, complications, co-morbid conditions and outcome of those neonates in terms of survival.Materials and Methods: Retrospective observational study of all neonates who underwent mechanical ventilation from 1 January 2014 to 31 December 2014 in NICU, Tribhuvan University Teaching Hospital. Medical records of the patients were retrieved from hospital record section to collect the relevant data.Results: One-third of admitted neonates in NICU required mechanical ventilation (MV). Commonest indication was severe respiratory distress (70%) followed by perinatal asphyxia (12%) and recurrent apnea (8%). Disease pattern were sepsis (37.2%), RDS of prematurity (17.6%), perinatal asphyxia (11.7%), meconium aspiration syndrome (9.8%), apnea of prematurity (7.8%) and congenital pneumonia (4%). Hospital acquired sepsis was a major complication occurring in 47% patients on mechanical ventilation. Survival rate among neonates on MV was 33%. Survival was better with increasing birth weight and gestational age. Survival was 100% in congenital pneumonia, 50% in perinatal asphyxia, 50% in recurrent apnea, 26% in sepsis, 20% in MAS and 0% in RDS of prematurity.Conclusion: Survival rate of neonates on mechanical ventilation in NICU was 33%. Sepsis was a major problem in NICU, which must be addressed to improve outcome.J Nepal Paediatr Soc 2015; 35(3): 218-223.

scholarly journals Etiological factors, clinical profile and outcome of meconium aspiration syndrome babies

2019 ◽  
Vol 6 (4) ◽  
pp. 1515
Author(s):  
R. Sasivarathan ◽  
A. Logesh Anand
Keyword(s):  
Respiratory Distress ◽  
Tamil Nadu ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
College Hospital ◽  
Severe Respiratory Distress ◽  
Etiological Factors

Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).Conclusions: MAS is known to cause severe respiratory distress and Downe’s score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.

Growth and Development of Infants Weighing Less Than 800 Grams at Birth

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Forrest C. Bennett ◽  
Nancy M. Robinson ◽  
Clifford J. Sells
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Pulmonary Disease ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Neurodevelopmental Outcome ◽  
Extremely Low Birth Weight ◽  
Chronic Pulmonary Disease ◽  
Symptomatic Intracranial Hemorrhage ◽  
A Prospective Study

A prospective study of infants weighing <800 g at birth and cared for in a single neonatal intensive care unit between 1977 and 1980 was conducted. Neonatal mortality was 80%; neurodevelopmental outcome was assessed in 16 of the 18 survivors. Mean birth weight for these 16 was 730 g; mean gestational age was 26 weeks. Perinatal asphyxia, respiratory distress, apnea, mechanical ventilation, and chronic pulmonary disease were commonplace. Symptomatic intracranial hemorrhage, seizures, sepsis, or meningitis did not occur in survivors. Of the 16 infants, 13 (81%), including all three with birth weight <700 g, were without major CNS handicaps and were developing appropriately at 6 months to 3 years of age. Only one of the 16 had clearly subnormal mental development. None had a major visual or hearing impairment. Apgar scores at one and five minutes were significantly related to outcome; apnea, mechanical ventilation, and chronic pulmonary disease were not. These data suggest that a remarkably hopeful outcome is possible for the few survivors of extremely low birth weight.

scholarly journals NICU Admissions for Meconium Aspiration Syndrome before and after a National Resuscitation Program Suctioning Guideline Change

Children ◽  
2019 ◽  
Vol 6 (5) ◽  
pp. 68 ◽  
Author(s):  
Erika M. Edwards ◽  
Satyan Lakshminrusimha ◽  
Danielle E. Y. Ehret ◽  
Jeffrey D. Horbar
Keyword(s):  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
The United States ◽  
Meconium Aspiration Syndrome ◽  
High Frequency Ventilation ◽  
Network Member ◽  
Endotracheal Suctioning ◽  
Subsequent Increase ◽  
Severe Respiratory Distress ◽  
Meconium Aspiration

The Textbook of Neonatal Resuscitation, seventh edition, does not suggest routine endotracheal suctioning for non-vigorous infants born through meconium-stained amniotic fluid. We compared 301,150 infants at ≥35 weeks’ gestational age inborn at 311 Vermont Oxford Network member centers in the United States (U.S.) and admitted to neonatal intensive care units (NICU) who were born before (2013 to 2015) and after (2017) the guideline change. Logistic regression models adjusting for clustering of infants within centers were used to calculate risk ratios. NICU admissions for infants with a diagnosis of meconium aspiration syndrome (MAS) decreased from 1.8% to 1.5% (risk ratio: 0.82; 95% confidence interval: 0.68, 0.97) and delivery room endotracheal suctioning in this group decreased from 57.0% to 28.9% (0.51; 0.41, 0.62). Treatment with conventional or high frequency ventilation, inhaled nitric oxide, or extracorporeal membrane oxygenation remained unchanged 42.3% vs. 40.3% (0.95; 0.80, 1.13) among infants with MAS and 9.1% vs. 8.2% (0.91; 0.87, 0.95) among infants without MAS. The use of surfactant among infants with MAS increased from 24.6% to 30% (1.22; 1.02, 1.48). Mortality (2.6 to 2.9%, 1.12; 0.74, 1.69) and moderate/severe hypoxic-ischemic encephalopathy (5.4 to 6.8%, 1.24; 0.91, 1.69) increased slightly in 2017. Subgroup analyses of infants with 1 min Apgar scores of ≤3 found similar results. While NICU admissions for MAS and tracheal suctioning decreased after the introduction of the new guideline with no subsequent increase in severe respiratory distress among infants with and without a MAS diagnosis, limitations in our study preclude inferring that the new guideline is safe or effective.

scholarly journals Disease pattern and Biochemical profile as a predictor of outcome of Critically sick neonates in a Neonatal Intensive Care Unit

2020 ◽  
Vol 10 (2) ◽  
pp. 381-385
Author(s):  
Mir Mohammad Yusuf ◽  
BH Nazma Yasmeen ◽  
MAK Azad Chowdhury
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Severe Infection ◽  
Biochemical Profile ◽  
Acid Base ◽  
Disease Pattern ◽  
Acute Neurological Deterioration

Background: Neonatal Intensive Care Unit (NICU) is predominately concerned with the management of critically sick neonates having acute life threatening conditions. Usually neonates having respiratory distress, acute neurological deterioration, severe infection and prematurity contribute the major admission in a NICU. Objective: To find out the disease pattern and biochemical profile as a predictor of outcome of critically sick neonates in NICU. Methods: This observational prospective study was carried out at NICU of Dhaka Shishu (Children) Hospital from January 2015 to July 2015. Total 121 neonates were enrolled according to inclusion criteria and analyzed some important biochemical profile specially electrolyte and blood gas status as a part of proper management as well as to predict their outcome. Results: Among critically sick neonates, perinatal asphyxia was common disorder followed by sepsis. Biochemical profile specially electrolyte and acid-base disruption play important role to the outcome of critically sick neonates. Low pH, low potassium and high base-deficit level were found to have worse outcome. Conclusion: Perinatal asphyxia constitutemajor cause of admission ofcritically sick neonates. Early detection of electrolyte and acid-base status is helpful to care and overall survival of these neonates. Mortality was the highest among neonatal sepsis followedby perinatal asphyxia. Metabolic acidosis and hypokalemia were the predictor of outcome of such critically sick neonates. Northern International Medical College Journal Vol.10 (2) Jan 2019: 381-385

Outcome, Clinical Profile and Risk Factors for Mortality of Neonates Necessitating Mechanical Ventilation

2021 ◽  
Vol 15 (12) ◽  
pp. 3485-3487
Author(s):  
Amber Naseer ◽  
Riffat Farrukh ◽  
Shaheen Masood ◽  
Sarwat Sultana ◽  
Qamar Rizvi
Keyword(s):  
Mechanical Ventilation ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Peak Inspiratory Pressure ◽  
Assisted Ventilation ◽  
Pulmonary Haemorrhage ◽  
Assisted Delivery ◽  
One Year ◽  
The Many ◽  
Excess Base

Background: Assisted ventilation has turn out to be an essential part of the neonatal intensive care unit (NICU). It is one of the main methods of support in the ICU and undoubtedly influences the survival of sick newborns. Aims: 1. To investigate common indications for mechanical ventilation in newborns 2. To investigate factors influencing the outcome. Method: It is a descriptive study of 60 infants admitted to the Department of Pediatric Medicine in the ICU over a one-year period in the department of Paediatrics, Abbasi Shaheed Hospital. The information was gathered and analysed in a pre-designed format. Results: Of a total of 60 infants, 46 survived, 14 died, and one infant was discharged despite medical advice. 36 children were born vaginally, 20 were born via LSCS, and 4 via assisted delivery. Postnatal asphyxia was the most common ventilation indication in full-term newborns, while HMD was present in preterm infants. The best results were obtained in ventilated infants with MAS, with 100% survival, followed by apnoea in premature infants, perinatal asphyxia, and HMD. Pulmonary haemorrhage (48.3%) was the most common complication among deceased infants, followed by sepsis (28.3%) and shock (23.4%) with a significant p <0.05. There were no complications in 76.7% of the surviving infants. Conclusions: Among the many widely available variables studied in this study, maximum and mean peak inspiratory pressure (PIP or (PEEP), maximum respiratory rate, maximum mean airway pressure (MAP) and average ventilation demand was much greater among non-survivals in comparison to the survivors. Bicarbonate, PH and excess base have been found to be important determinants of mortality in ventilated newborns. Keywords: Indications, mechanical ventilation and Results

scholarly journals Meconium-stained amniotic fluid as a risk factor for perinatal asphyxia

2019 ◽  
Vol 6 (2) ◽  
pp. 325
Author(s):  
Vidhi Mehta ◽  
Adarsh E. ◽  
Spoorthi . ◽  
Archana . ◽  
Muhammed Hassan
Keyword(s):  
Amniotic Fluid ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Efficient Delivery ◽  
Meconium Stained Amniotic Fluid ◽  
Delivery Room Management

Background: The aim of this study was to find out immediate fetal outcome in meconium-stained amniotic fluid in relation to perinatal asphyxia.Methods: This retrospective study includes medical records of all neonates admitted to Neonatal Intensive Care Unit (NICU) between December 2016 and July 2018. The variables reviewed are age, sex, weight, mode of delivery, gestational age, presence of meconium aspiration syndrome (MAS) and perinatal asphyxia.Results: Out of 408 total admissions in NICU, 69.1% were male babies and remaining 30.9% were female babies. In the study out of 36 subjects with Perinatal Asphyxia, 38.9% had MAS and 61.1% had not MAS. Out of 372 subjects without perinatal asphyxia, 93.8% had no MAS and 6.2% had MAS. There was significant association between MAS and perinatal asphyxia. Odds ratio was 9.656. i.e. those with MAS had 9.656 times higher risk for perinatal asphyxia.Conclusions: The management of MAS, which is a perinatal problem, requires a well concerted and coordinated action by the obstetrician and pediatrician. Prompt and efficient delivery room management can minimize the sequelae of aspirated meconium and decrease the chance of perinatal asphyxia in the new born babies.

scholarly journals Etiology of Respiratory Distress in Newborn – Experience in BIRDEM

2013 ◽  
Vol 3 (1) ◽  
pp. 19-22
Author(s):  
Afroza Haque ◽  
MA Baki ◽  
Tahmina Begum ◽  
Shahida Akhter ◽  
Suraiya Begum ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Perinatal Asphyxia ◽  
Male Predominance ◽  
Common Causes ◽  
Common Etiology ◽  
Preterm Babies

Objectives: Respiratory distress is one of the most common causes of admission in Neonatal intensive care unit (NICU). There are many causes of respiratory distress, among them, transient tachypnoea of newborn, respiratory distress syndrome and perinatal asphyxia are commonest causes. The aim of this study was to identify the etiology of respiratory distress in special care baby unit (SCABU) in BIRDEM General Hospital and to observe the immediate hospital outcome of these babies. Methods: A retrospective study was conducted in SCABU, BIRDEM. Data were collected from all patients files admitted in to SCABU during the period from January to December 2011. Results: A total of 562 patients were admitted, among them 192 cases were admitted due to respiratory distress (34.1%). There was male predominance (64.6%). Two third (65.6%) babies were inborn and majority (84.4%) were born by caesarian section and preterm babies were more (65.6%). The commonest causes of respiratory distress in our study were transient tachypnea of newborn (43.2%), respiratory distress syndrome (30.2%), perinatal asphyxia (25%), septicaemia (16.1%) congenital pneumonia (11.9%), congenital heart disease (10.4%). All babies required oxygen initially, subsequently mechanical ventilation and Bubble CPAP was required in 48 (25.0%) and 8(04.1%) cases respectively. Mortality was 16.7% and was highest in neonates with respiratory distress syndrome (RDS) (71.8%) followed by septicaemia (40.6%) and perinatal asphyxia (37.3%). Among neonates requiring mechanical ventilation 56.2% died. Conclusion: Transient tachypnoea of newborn (TTN), respiratory distress syndrome (RDS), perinatal asphyxia and septicaemia were the common etiology for respiratory distress. Mortality was very high in RDS and septicaemia. Birdem Med J 2013; 3(1): 19-22 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17122

scholarly journals Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Kiran Panthee ◽  
Kiran Sharma ◽  
Balkrishna Kalakheti ◽  
Kul Thapa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Survival Rate ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
College Teaching ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Medical College

Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.   Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of  more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).   Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.   Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

scholarly journals Audit of Neonatal Morbidity and Mortality in A Tertiary Care Hospital, Sylhet

2017 ◽  
Vol 15 (2) ◽  
pp. 45-48
Author(s):  
Farzana Hamid ◽  
Syed Moosa MA Quaium ◽  
Azizur Rahman ◽  
AT Reza Ahmad ◽  
Shahariar Khan ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Neonatal Unit ◽  
Care Hospital ◽  
Disease Pattern

Background: To know the disease pattern and causes of morbidity & mortality of patients admitted to the neonatal unit in a tertiary care hospital in Sylhet, Bangladesh.Methods: This retrospective study was conducted in the neonatal unit from December 2014 to November 2015. Data of all the patients admitted to the neonatal unit during study period was analyzed for, age, sex, weight, gestational age, place and mode of delivery, maternal antenatal events, disease pattern and their outcome.Results: A total of 985 patients were admitted during study period. Among 985 cases 566(57.5%) were male and 419(42.5%) were female. 450(45.6%) were admitted at the age of less than 24 hours. 122 (12.4%) were preterm babies. 202(20.5%) were low birth weight. 693(70.4%) were delivered in hospital. Main causes of admission were perinatal asphyxia 398(40.4%), neonatal sepsis164 (16.6%), preterm LBW 122(12.4%), Meconium Stained Baby (MSB) 88(8.9%), Intrauterine Growth Retardation (IUGR) 80(8.1%), neonatal jaundice 62(6.2%), Infant of Diabetic Mother (IDM) 30(3.0%), Transient Tachypnoea of Newborn (TTN) 15(1.5%), Meconium Aspiration Syndrome (MAS) 10(1.1%), Respiratory Distress Syndrome (RDS) 6(0.6%) and congenital anomaly 10(1.1%). Most of the deaths were associated with preterm LBW (6.5%), perinatal asphyxia with Hypoxic Ischaemic Encephalopathy (HIE) (4.5%), sepsis (2.4%), RDS (16.7%), MAS (10%).Conclusion: Preterm LBW, perinatal asphyxia and neonatal sepsis were the three leading cause of neonatal morbidity & mortality. These findings could be important in identifying the areas requiring attention to improve the perinatal care and also to manage the problems associated with them.Chatt Maa Shi Hosp Med Coll J; Vol.15 (2); Jul 2016; Page 45-48

scholarly journals Short-Term Outcome of Mechanical Ventilation in Neonates

2011 ◽  
Vol 31 (1) ◽  
pp. 35-38 ◽  
Author(s):  
SM Gurubacharya ◽  
DR Aryal ◽  
M Misra ◽  
R Gurung
Keyword(s):  
Mechanical Ventilation ◽  
Survival Rate ◽  
Birth Asphyxia ◽  
Hyaline Membrane Disease ◽  
Meconium Aspiration Syndrome ◽  
Western World ◽  
Term Outcome ◽  
Level Ii ◽  
Neonatal Ventilation ◽  
Hyaline Membrane

Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. As compared to the Western world and our neighbouring countries, neonatal ventilation in our country is still in its infancy. Objectives: To analyze the common indications and outcome of neonates requiring mechanical ventilation. Methods: This was a prospective observational study conducted on neonates requiring mechanical ventilation within first 24 hours of birth over a period of nine months. Results: Birth asphyxia was the commonest indication for ventilation (59.67%) followed by asphyxia with meconium aspiration syndrome (MAS) (17.74%), hyaline membrane disease (HMD) (8.06%), MAS (6.45%) and intrauterine pneumonia (6.45%). Out of 62 babies, 22 (35.48%) survived. Babies with asphyxia had highest survival rate (51.35%). Neonates with HMD did not survive. Term babies and babies weighing ≥2500g had higher survival rate of 40.47% and 41.46% respectively, while babies less than 32 weeks had survival rate of 16.66% only. Conclusions: Mechanical ventilation reduces the neonatal mortality; hence, facilities for neonatal ventilation should be included in the regional and central hospitals providing level II neonatal care. Key words: neonatal ventilation; hyaline membrane disease; low birth weight DOI: 10.3126/jnps.v31i1.3463J Nep Paedtr Soc 2010;31(1):35-38

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