All issues > Volume 33(1); 1990

Original Article

J Korean Pediatr Soc. 1990;33(1):10-21. Published online January 31, 1990.

Mechanical Ventilation in Newborn Infants.

Young Back Hahm¹, Jong Ho Sung¹, In Kyung Sung¹, Byung Churl Lee¹, Du Bong Lee¹

¹Department of Pediatrics, Catholic University Medical College, Seoul, Korea

Received: August 19, 1989;  Accepted: October 20, 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%).

Keywords :Mechanical ventilation, Newborn