title: Neonatal mechanical ventilation: Indications and outcome.
abstract: OBJECTIVE
  Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identification of risk factors is important. This study was undertaken to find out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome.
  
  
  METHODS
  Age <1-month; mechanically ventilated; not having suspected metabolic disorders or congenital anomalies; excluding postoperative patients.
  
  
  METHODS
  Neonates consecutively put on mechanical ventilation during the study period (October 2011 to November 2013) enrolled. Primary disease of the neonates along with complications present listed. Clinical and laboratory parameters analyzed to find the predictors of mortality.
  
  
  RESULTS
  Total 300 neonates were ventilated. 52% were male. Mean age, weight, and gestational age were 21 ± 62 h, 2320 ± 846.2 g, and 35.2 ± 4.9 weeks, respectively. 130 (43%) neonates died. Respiratory distress syndrome (RDS) (31.1%), sepsis (22.7%), and birth asphyxia (18%) were the most common indications for ventilation. Mortality in ventilated patients with sepsis, pneumonia, RDS or birth asphyxia was 64.7%, 60%, 44.6%, and 33.3%, respectively. Weight <2500 g, gestation <34 weeks, initial pH <7.1, presence of sepsis, apnea, shock, pulmonary hemorrhage, hypoglycemia, neutropenia, and thrombocytopenia were significantly associated with mortality (P < 0.05). Resuscitation at birth, seizures, intra ventricular hemorrhage, pneumothorax, ventilator-associated pneumonia, PO2, or PCO2 did not have a significant association with mortality. On logistic regression, gestation <34 weeks, initial pH <7.1, pulmonary hemorrhage, or shock were independently significant predictors of mortality.
  
  
  CONCLUSIONS
  Weight <2500 g, gestation <34 weeks, initial arterial pH <7.1, shock, pulmonary hemorrhage, apnea, hypoglycemia, neutropenia, and thrombocytopenia were significant predictors of mortality in ventilated neonates.
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Qazi
authors.initials: Q
authors.lastname: Iqbal
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Mir M
authors.initials: MM
authors.lastname: Younus
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Asif
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Ikhlas
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Javed
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: Bashir A
authors.initials: BA
authors.lastname: Charoo
authors.affiliation: Department of Neonatology and Pediatrics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: S Wajid
authors.initials: SW
authors.lastname: Ali
keywords: Complications of ventilation; neonatal mechanical ventilation; predictors of mortality