Prognosis of neonates with symptomatic respiratory insufficiency surviving with the aid of ventilator therapy.

Twenty-one survivors representing all survivors of neonatal symptomatic respiratory distress treated with intermittent positive pressure ventilation have been follow-up at an age of 2.9 to 7.0 years. The chance of survival proved to be relatively favourable in infants ventilated for perinatal pneumonias and unfavourable in infants ventilated for haemorrhagic diseases and respiratory insufficiency secondary to surgical conditions. At the follow-up half of the children presented with neurological symptoms but only 10% were found severely handicapped. One infant had a tracheostomy due to a laryngeal stenosis, while none developed broncho-pulmonary dysplasia. The late prognosis seemed unfavourable when the children had suffered from severe birth asphyxia and in infants ventilated for prolonged recurrent apnoeic spells. The relation between the clinical indications for ventilator therapy and later outcome is obscured however, by a vase number of complicating perinatal events.