Journal of Clinical and Experimental Investigations

Abstract

Objectives: To evaluate mortality, morbidity, and invasive mechanical ventilation complications in mechanically ventilated neonates in a tertiary care hospital, Istanbul, Turkey.
Materials and methods: The neonates followed on invasive mechanical ventilation from January 2008 to December 2009 were included in the study. A chart is formed for each patient to record patient delivery room and clinical data prospectively.
Results: The study population consisted of 236 neonates. Eighty-five percent were born at ≤37 completed weeks of gestation (n=201). Fifty-two percent (n=123) were males. The mean gestational age was 31.9±5 weeks. The mean birthweight was 1870.8±921.8 g. Antenatal steroid rate was 13.3% (n=20) in 150 cases born at ≤34 weeks of gestation. Respiratory distress syndrome (n=100, 42,3%), perinatal depression and asphyxia (n=51, 21,6%), and sepsis (n=47, 19.9%) were the commonest indications. Mechanical ventilation related complications (nosocomial infection (n=57), pulmonary hemorrhage (n=30), pneumonia (n=10), pneumothorax (n=9), and atelectasis (n=4)) developed in 33.5% of neonates (n=79). Bronchopulmonary dysplasia was 9.3%, intracranial hemorrhage (≥grade 3) 8.47%, periventricular leukomalacia 5.93%, necrotizing enterocolitis (>stage 2) 0.42%, and retinopathy of prematurity (>stage 2) 2.96%. Mortality rate was 30.17%. Neonates born at <28 weeks of gestation and with birthweight ≤1000 gram had statistically higher mortality rate than the neonates born at ≥28 weeks of gestation and with birth weight >1000 gram (p<0.05, p<0.05, respectively).
Conclusions: Low birthweight and low gestational age are important risk factors for neonatal mortality and morbidity. Low frequency of antenatal steroid use may be a contributing factor to increase neonatal mortality and morbidity.