Manual Ventilation in Neonates to save Pediatric Emergency
Written By : Dr. Nandita Mohan
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2022-09-27 06:30 GMT | Update On 2022-09-27 09:57 GMT
In our country, the biggest question posing is managing neonates and children in need of positive pressure ventilation (PPV) with manual ventilation are not an uncommon practice due to a lack of adequate resources, but due to lack of data on the outcome of manually ventilated neonates. This study was conducted to determine the short-term outcome of manually ventilated out born neonates admitted in pediatric emergency of tertiary care hospital in North India.
The retrospective study was conducted involving, 131 out born neonates who were manually ventilated with self-inflating bags (SIBs). Details regarding demographic variables, perinatal period, treatment received, ventilation, the reason for intubation and positive pressure ventilation, duration of intubation, complications related to positive pressure ventilation, diagnosis, and final outcome were noted.
The mean age of neonates were around 5 days and 76% of them were males. The common diagnoses were hypoxic-ischemic encephalopathy (HIE), early-onset neonatal sepsis (EONS), late-onset neonatal sepsis (LONS), and hyaline membrane disease (HMD). The survival rate was 22.1%. and 45.8% of cases died, and 32.1% left against medical advice (LAMA).
So, in conclusion One-fifth of manually ventilated outborn neonates survived. Complications related to positive pressure ventilation, and presence of shock, and hypoxic-ischemic encephalopathy were an independent predictor of poor outcome. Therefore, the facilities for the care of outborn neonates need to be upgraded, but in the setting where these facilities are not available, the provision of manual ventilation may save a significant number of babies.
Reference:
Anne RP, Angurana SK, Kumar P, et al. Short-term Outcome of Manually Ventilated Outborn Neonates Admitted in Pediatric Emergency of a Developing Economy. J Postgrad Med Edu Res 2022;56(2):75–80.
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