Predictors of fatality in neonates requiring mechanical ventilation.

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dc.contributor.authorMathur, N Ben_US
dc.contributor.authorGarg, Pankajen_US
dc.contributor.authorMishra, T Ken_US
dc.date.accessioned2005-07-09en_US
dc.date.accessioned2009-05-27T05:38:41Z
dc.date.available2005-07-09en_US
dc.date.available2009-05-27T05:38:41Z
dc.date.issued2005-07-09en_US
dc.description.abstractOBJECTIVE: To evaluate initial arterial blood gas, pulmonary pressures, pulmonary mechanics (compliance and resistance), pulmonary volumes, oxygenation indices and serum carotenoid levels as predictors of fatality in mechanically ventilated neonates. DESIGN: Cross Sectional. SETTING: Referral neonatal unit of a teaching hospital. SUBJECTS: 83 mechanically ventilated outborn neonates. METHODS: 83 neonates consecutively put on mechanical ventilator from March to December 2001 were enrolled in the study. The mechanical ventilator used was pressure limited time cycled ventilator with facility for online measurement of volumes and pulmonary mechanics. Arterial blood gas after half an hour of initiation of mechanical ventilation and initial pulmonary pressures, pulmonary compliance, resistance and duration of mechanical ventilation were recorded in a pre structured proforma. Initial serum carotenoid levels were also measured using spectrophotometric method. The neonates were regularly followed up for outcome. Multiple logistic regression analysis was done to find out the predictors of fatality for those variables that were significantly associated with outcome on univariate analysis. RESULTS: On univariate analysis weight ( < 2000 g), gestational age <34 weeks, pH <7.3, duration of mechanical ventilation <72 hours, a/A <0.25, compliance <1 mL/cmH2O, fraction of inspired oxygen (FiO2) >60%, oxygenation index >10, AaDO2 >250 and serum carotenoid levels < 100 microg/dL were significantly associated with fatality in neonates requiring mechanical ventilation. However, on multiple regression analysis only FiO2, gestational age and serum carotenoids < 100 microg/dL were found to be independent predictors of fatality. CONCLUSIONS: Initial FiO2 > 60%, gestational age <34 weeks and initial serum carotenoid levels < 100 microg/dL were independent predictors of fatality in neonatal mechanical ventilation. Even in a setting with high fatality rates, high risk of mortality in mechanically ventilated neonates can be identified.en_US
dc.description.affiliationDepartment of Pediatrics, Maulana Azad Medical College, New Delhi 110 002, India. drmathur@nda.vsnl.net.inen_US
dc.identifier.citationMathur NB, Garg P, Mishra TK. Predictors of fatality in neonates requiring mechanical ventilation. Indian Pediatrics. 2005 Jul; 42(7): 645-51en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/12249
dc.language.isoengen_US
dc.source.urihttps://indianpediatrics.neten_US
dc.subject.meshCarotenoids --blooden_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshGestational Ageen_US
dc.subject.meshHospital Mortalityen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshInfant Mortalityen_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshRegression Analysisen_US
dc.subject.meshRespiration, Artificialen_US
dc.subject.meshRespiratory Distress Syndrome, Newborn --blooden_US
dc.subject.meshRespiratory Function Testsen_US
dc.subject.meshRisk Factorsen_US
dc.titlePredictors of fatality in neonates requiring mechanical ventilation.en_US
dc.typeJournal Articleen_US
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