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Mechanical Ventilation in Newborn Infants.

Journal of the Korean Pediatric Society 1990;33(1):10-21.
Published online January 31, 1990.
Mechanical Ventilation in Newborn Infants.
Young Back Hahm, Jong Ho Sung, In Kyung Sung, Byung Churl Lee, Du Bong Lee
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
호흡집중 치료를 시행한 신생아에 대한 임상적 관찰
함영백, 성종호, 성인경, 이병철, 이두봉
가톨릭의과대학 소아과학교실
Received: 19 August 1989   • Accepted: 20 October 1989
Abstract
Clinical analysis of 5 years* experience with mechanical ventilation of 68 neonates in NICU of St. Mary’s Hospital, from Jan. 1983 to June 1988, was done. The results were as follows; 1) Indications for mechanical ventilation were hyaline membrane disease(51.5%), postasphyxia syndrome(19.1%), apnea of prematurity (5.9%), sepsis (5.9%), intracranial hemorrhage (5.9%) and others. 2) Number of male patients was 33(48.5%》and of female was 35(51.5%), and male to female ratio was 1:1.1. 3) Premature infants of gestational age below 37 weeks were 50 cases (73.5%) and infants below 28 weeks of gestation were 22 cases (32.4%). Infants of weighing less that 2,500 gm were 52 cases (76. 5%), very-low-birth-weight infants(< 1,500gm) were 37 cases (54.4%) and extreme-low-birth-weight infants(≤ 999gm) were 15 cases (22.0%). 4) CPAP mode was used in 15 cases (22.1%), IPPV was applied in 63 cases (92.6%). In 47 cases (69.2%), assisted ventilation was initiated before 24 hours of age, and total duration of mechanical ventilation was within 72 hours in 49 cases (72%). 5) Complications noted during mechanical ventilation were infection (11.8%), air leaks(11.8%), endotracheal tube obstruction/displacement (8.8%), post-extubation atelectasis(5.9%), gastrointesti- nal or pulmonary hemorrhage (5.9%), intracranial hemorrhage(4.4%), bronchopulmonary dysplasia(4.4%). 6) Total survival rate was 41.2%. Survival rate in hyaline membrane disease was 42.9%, and postasphyxia syndrome 76.9%, apnea of prematurity 50%, sepsis 0%, intracranial hemorrahge 0%, others 12.5%. In hyaline membrane disease, survival rate of infants weighing less than 999 gm was 12. 5%, 1,000-1,499gm 40%, 1,500〜 1,999gm 50%, 2,000-2,499gm 100%, and birth weight, ges- tational age, 1 minute Apgar score were significantly different between survivors and non-survivors. 7) 19 cases(47.5%) of total 40 non-survivors died before 72 hours of life, and the major cause of death were infection (27.5%), respiratory failure (25%), intracranial hemorrhage(17.5%) and extrapulmonary air leaks (12.5%).
Key Words: Mechanical ventilation, Newborn


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