creators_name: Trivedi, SS creators_name: Chudasama, RK creators_name: Srivastava, A creators_id: dranakonda@yahoo.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2010-09-13 03:56:09 lastmod: 2011-03-11 08:57:41 metadata_visibility: show title: Study of Early Predictors of Fatality in Mechanically Ventilated Neonates in NICU ispublished: pub subjects: OJHAS full_text_status: public keywords: Mechanical ventilation, Neonates, Hypothermia, Capillary refill time abstract: Objective: To evaluate the risk factors associated with fatality in mechanically ventilated neonates using multiple regression analysis. Design & settings: Prospective study conducted at Neonatal ICU at New Civil Hospital, Surat – a tertiary care centre, from December, 2007 to May, 2008 for 6 months. Methods: Fifty neonates in NICU consecutively put on mechanical ventilator during study period were enrolled in the study. The pressure limited time cycled ventilator was used. All admitted neonates were subjected to an arterial blood gas analysis along with a set of investigations to look for pulmonary maturity, infections, renal function, hyperbilirubinemia, intraventricular hemorrhage and congenital anomalies. Different investigation facilities were used as and when required during ventilation of neonates. Multiple logistic regression analysis was done to find out the predictors of fatality among these neonates. Results: Various factors suspected as predictors of fatality of mechanically ventilated neonates were assessed. Hypothermia, prolonged capillary refill time (CRT), initial requirement of oxygen fraction (FiO2) >0.6, alveolar to arterial PO2 difference (AaDO2) >250, alveolar to arterial PO2 ratio (a/A) <0.25, & oxygenation index (OI) >10 were found statistically highly significant predictors of mortality among mechanically ventilated neonates. Conclusion: Hypothermia and prolonged capillary refill time were independent predictors of fatality in neonatal mechanical ventilation. Risk of fatality can be identified in mechanically ventilated neonates. date: 2009-11-15 date_type: published publication: Online Journal of Health and Allied Sciences volume: 8 number: 3 publisher: Dr. BS Kakkilaya refereed: TRUE referencetext: 1. Park K. Textbook of Preventive & Social Medicine. 19th edition. Jabalpur: M/s Banarasidas Bhanot Publishers; 2007. p.453-454.. 2. Singh M. Care of Newborn. 6th Edition. Sagar Publications. 2004. 3. Jain S, Gangrade A, Harshey M. Pediatric mechanical ventilation in India: need, indications, cost and problems. Indian Pediatr. 1994;31:725-726. 4. Narang A, Kiran PS, Kumar P. Cost of neonatal intensive care in a tertiary care center. Indian Pediatr. 2005;42:989-997. 5. Goldsmith JP, Karotkin EH. Assisted ventilation of the Neonate. 4th edition. Saunders 2003. 6. Rogers MC. Textbook of pediatric intensive care. Vol 1. Williams & Wilkins 1987. 7. Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of pediatrics. 17th edition. Saunders 2004. 8. Nangia S, Saili A, Dutta AK, et al. Neonatal mechanical ventilation. Experience at a level II care centre. Indian J Pediatr 1998;65:291-296. 9. Mathur NC, Kumar S, Prasanna AL, et al. Intermittent positive pressure ventilation in a neonatal intensive care unit: Hyderabad experience. Indian Pediatr 1998;35:349-353. 10. Singh M, Deorari AK, Paul VK, et al. Three year experience with neonatal ventilation from a tertiary care hospital in Delhi. Indian Pediatr 1993;30:783-789. 11. Mathur NB, Garg P, Mishra TK. Predictors of fatality in neonates requiring mechanical ventilation. Indian Pediatr 2005;42:645-651. 12. Malhotra AK, Nagpal R, Gupta RK, et al. Respiratory distress in newborn: treated with ventilation in a level II nursery. Indian Pediatr 1995;32:207-212. 13. Singh M, Deorari AK, Aggrawal R, et al. Assisted ventilation for hyaline membrane disease. Indian Pediatr 1995;32:1267-1274. 14. Maiya PP, Vishwanath D, Hegde S, et al. Mechanical ventilation of newborns: experience from a level II NICU. Indian Pediatr 1995;32:1275-1280. 15. Karthikeyan G, Hossain MM. Conventional ventilation in neonates: experience from Saudi Arabia. Indian J Pediatr 2002;69:15-18. 16. Harris TR, Wood BR. Physiologic principles. In: assisted ventilation of the neonate. Eds Goldsmith SP, Karotkin EH. 3rd edn. Philadelphia, WB Sounders, 1996; p 21-68. citation: Trivedi, SS and Chudasama, RK and Srivastava, A (2009) Study of Early Predictors of Fatality in Mechanically Ventilated Neonates in NICU. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/6956/1/2009-3-9.pdf