Predictors of Mortality in Ventilated Neonates in Intensive Care Unit

Abstract

Background: A large number of neonates in intensive care unit require mechanicalventilation due to various conditions and have a high mortality. To reduce the highmortality in this group of neonates, identification of risk factors is important.Objective: This study was undertaken to find out the predictors of mortality in ventilatedneonates in the Intensive Care Unit.Methods: This study was carried out in the Intensive Care Unit of Dhaka ShishuHospital from March 2006 to November 2006. Neonates consecutively put onmechanical ventilation during the study period were enrolled. The enrolled neonateswere divided into two groups; neonates who died after putting to the ventilator were ingroup-I and neonates who survived after receiving mechanical ventilation were ingroup-II. Clinical, biochemical and ventilator parameters were analyzed to find out thepredictors of mortality of ventilated neonates.Results: During the study period total 51 out born very critically sick neonates wereventilated due to different causes. Out of these 51 neonates, 58.8% were male with amale to female ratio 1.42:1. Mean age, weight and gestational age were 5.3±6.5 days,2171±796.2 gm and 34.8±4.1 weeks respectively. Out of 51 mechanically ventilatedneonates enrolled for this study, 70.6% died. Factors significantly different in nonsurvivorswere mean weight, mean gestational age, initial arterial pH and duration ofhospital stay (p<0.05). Weight <2500gm, gestation <34weeks, initial pH <7.1, PaCO2>60 mmHg, serum sodium <130 mmol/l, serum potassium <3.5 mmol/l and FiO2>60% were significantly associated with mortality in neonates requiring mechanicalventilation (p <0.05). Significant relation with mortality was found in those neonateswho developed complications during ventilation (p=0.01).Conclusion: Among the analyzed factors weight <2500gm, gestation <34weeks,initial arterial pH <7.1, O2 saturation<80%, PaCO2 >60mmHg, FiO2 >60%,hyponatremia, hypokalemia and complications during ventilation were the significantpredictors of mortality in ventilated neonates in the intensive care unit.Key words: Neonates; mechanical ventilation; predictors of mortality.DOI: 10.3329/bjch.v33i3.5687Bangladesh Journal of Child Health 2009; Vol.33(3): 77-82