OUTCOME OF VENTILATION IN HYALINE MEMBRANE DISEASE: THE INDIAN EXPERIENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 52
Abstract
OBJECTIVE To study the short-term outcome of both preterm and term babies requiring assisted ventilation for hyaline membrane disease and report the complications contributing to morbidity and mortality of these patients from a regional medical college with limited resources. DESIGN Retrospective file review. SETTING Regional Medical College. PARTICIPANTS All babies ventilated for HMD over a 6-year period from June 2008 to June 2014. OUTCOME MEASURES Outcome of ventilation and factors contributing to mortality. RESULTS Out of 100 babies with hyaline membrane disease who were ventilated, 82% survived. Increasing gestational age and birth weight was associated with survival. The commonest complication was shock (77%) and the commonest cause of mortality was septicaemia (77%). Septicaemia, Disseminated Intravascular Coagulation (DIC) and pulmonary haemorrhage were significantly more common complications babies who died (p<0.05). Binary logistic regression analysis showed that DIC (Odds ratio 5.2 [Confidence intervals (C.I.) 1.1-27.1]) and pulmonary haemorrhage (OR 18 [1.72-45.2]) to be predictors of mortality. The incidence of intraventricular haemorrhage was 1% and that of pneumothorax was 2%. The initial peak inspiratory pressure administered was significantly lower (p=0.033) and maximum peak end expiratory pressure was significantly higher in those who expired (p=0.027). CONCLUSION Outcome of ventilation for hyaline membrane disease improves with increasing gestational age and birth weight. The commonest cause of mortality and morbidity were septicaemia and shock respectively
Authors and Affiliations
Nayana P. C, Somasekharan K. S, Junaid M. I
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