Mortality Risk in Mechanically Ventilated Neonates: A Developing Country Experience

Abstract

Background & Objectives:Despite the great improvement in the outcome of sick neonates after the effective widespread introduction of mechanical ventilation in neonatal intensive care units, a significant proportion of high fatality is still detected among them. This study was conducted to identify the complications, outcome, and causes of death among a sample of critically ill Egyptian neonates mechanically ventilated using pressure-control-mode.Patients & Methods:Two-hundred-forty patients fulfilling the study inclusion criteria were prospectively enrolled in the current study. Those with multiple congenital malformations or post-surgical cases were excluded from the study. Data regarding history taking, clinical examination, indication for mechanical ventilation, complications related to mechanical ventilation and outcome were collected, recorded and analyzed. Results: The incidence of complications related to mechanical ventilation was 104 (43.3%) with reported increase in the incidence of VAP (20%). Also, the incidence of complications related to disease pattern was 136 (56.7%) with reported increase in the incidence of sepsis & septic shock (22.5%). It has been observed that 124 (51.7%) of the studied neonates had favorable outcome, however, the remaining 116 (48.3%) unfortunately expired with significant increase in the incidence of VAP among the expired group (P=0.013). Smaller gestational age and lower birth weight were the most significant risk factors. Conclusions:In Egypt; as an example of developing countries; mortality among critically ill mechanically ventilated pressure-control-mode neonates is significantly high approaching 48.3% with VAP being the most common cause of death.