Indications, complications and short term outcomes of mechanical ventilation in NICU.

Objective: To determine the indications, complications and outcome of neonates requiring mechanical ventilation in neonatal intensive care unit (NICU). Study Design: Cross-sectional study. Setting: The NICU of National Institute of Child Health (NICH), Karachi, Pakistan. Period: February 2024 to July 2024. Methods: A total of 89 neonates who required mechanical ventilation for at least 6 hours were analyzed. At the time of enrollment, gender, age (day of life), gestational age (weeks), birth weight (grams), place of birth, and mode of delivery were noted. Main cause influencing need for mechanical ventilation was also documented. During the course of mechanical ventilation, associated complications were recorded. Outcome was noted in the form of survival or death. Results: In a total of 89 neonates, 54 (60.7%) were boys. The mean age was 10.64±9.67 days. The most common causes behind the need for mechanical ventilation were sepsis, perinatal asphyxia, tetanus, and RDS, noted in 26 (29.2%), 22 (24.7%), 14 (15.7%), and 12 (13.5%) neonates, respectively. The most frequent mechanical ventilation associated complications were pneumonia, pulmonary hemorrhage, atelectasis, and pneumothorax, observed in 23 (25.8%), 12 (13.5%), 6 (6.7%), and 2 (2.2%), respectively. The mean duration of mechanical ventilation was 6.97±5.87 days (ranging between 2 to 25 days). Mortality was reported in 44 (49.4%) neonates. Conclusion: The most common causes behind the need for mechanical ventilation were sepsis and perinatal asphyxia. The most frequent mechanical ventilation associated complications were pneumonia, and pulmonary hemorrhage, while overall mortality was very high.