Assisted ventilation for hyaline membrane disease.

OBJECTIVES

To study the outcome and complications of assisted ventilation in neonates with hyaline membrane disease (HMD).

DESIGN

Retrospective study.

SETTING

Hospital based.

SUBJECTS

Seventy five premature neonates with HMD needing assisted ventilation born over a period of five years.

MAIN OUTCOME MEASURES

Survival rate among those ventilated and complications of assisted ventilation.

RESULTS

Survival on assisted ventilation improved from initial 22.2% in 1989 to 77.8% in 1993. Of 19 babies weighing between 750-1000 g, 8(42.1%) survived. Twelve of 27 babies (44.4%) with a gestation of less than 28 weeks survived. Survival rates in babies with gestation of more than 33 weeks was 94%. Intraventricular hemorrhage was the leading cause of death in 52% babies. Nosocomial infections were common and occurred in 50.6% of infants on ventilation and accounted for one-third of deaths. Pneumothorax occurred in one-fifth of babies and was responsible for 3 deaths. Pulmonary interstitial emphysems was observed in 6 babies. Six babies developed bronchopulmonary dysplasia while 7 had retinopathy of prematurity.

CONCLUSIONS

Outcome of neonates needing assisted ventilation for HMD has shown consistent improvement over the period of study. Nosocomial infections continue to be a major complication of assisted ventilation in neonates.