Assisted ventilation for hyaline membrane disease

Abstract

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.