Characteristics of infants requiring mechanical reventilation in those previously ventilated during the neonatal period
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Abstract
Background. Factors predisposing ventilated neonates to the risk for reventilation during infancy are largely unknown.
Objective. To identify factors that predispose previously mechanically ventilated neonates to reventilation.
Methods. Mechanically ventilated infants at the Inkosi Albert Luthuli Central Hospital paedicatric intensive care unit (PICU), South
Africa, who were also ventilated during the neonatal period were compared with age-, gender-, timing-, and site-matched controls who
were not reventilated during infancy. Neonatal and postnatal records of the two cohorts and data on their clinical presentation and
outcomes of the ICU admission were collected and analysed using descriptive and comparative statistics.
Results. Thirty-one reventilated index cases were identified at the PICU over a 15-month period and were matched with 31
non-reventilated controls. Ex-preterm babies (n=26; 84%), males (n=19; 61.3%), chronic lung disease (CLD) of infancy (n=5; 16.7%)
and prolonged neonatal length of stay (LOS) were common neonatal factors in reventilated neonates. Pneumonia (n=22; 71%), sepsis
(n=11; 35.5%) and upper airway obstruction (UAO) (n=8; 25.8%) were common reasons for reventilation in neonates. There were no
HIV-positive cases. Of the 31 reventilated cases, 5 (16.1%) demised and 15 (57.6%) survivors had morbidities, commonly seizures (n=8;
30.8%) and short bowel syndrome (n=3; 11.5%).
Conclusion. Pre-term birth, male, CLD of infancy and prolonged LOS were associated with an increased risk for mechanical reventilation
in infancy. Pneumonia, sepsis, CLD of infancy and UAO were common indications for reventilation post neonatal ICU discharge.
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References
American Academy of Pediatrics Committee on Fetus and Newborn. Hospital discharge of the high-risk neonate. Am Acad Paediatr 2008;122(5):1119-1126. https://doi.org/10.1542/peds.2008-2174
Elder DE, Hagan R, Evans SF, et al. Hospital admissions in the first year of life in very preterm infants. J Paediatr Child Health 1999;35(2):145-150. https://doi. org/10.1046/j.1440-1754.1999. 00308.x
Greenough A, Cox S, Alexander J, et al. Health care utilisation of infants with chronic lung disease related to hospitalisation for RSV infection. Arch Dis Childhood 2001;85(6):463-468 https://doi.org/10.1136/adc85.6.463
Underwood M, Danielsen B, Gilbert WM. Cost, causes and rates of rehospitalisation of preterm infants. J Perinatol 2007;27(10):614-619 https:// 10.1038/sj.jp.7211801
Mourani PM, Kinsella JP, Clermont G, et al. Intensive care unit readmission 10. during childhood after preterm birth with respiratory failure. J Pediatr 2014;164(4):749-755.e3. https://doi.org/10.1016/j.jpeds.2013.11.062
Doctor TN, Harnaen E, Seith B, Tan K, Craig S. Risk factors for hospital 11. readmission and follow-up after NICU discharge of infants born at extremely
low gestational age in metropolitan Melbourne. Int J Pediatr Res 2017;3:028. https://doi.org/10.23937/2469-5769/1510028 12.
Mannan A, Jahan N, Iqbal S, et al. Short-term outcome of preterm neonates required mechanical ventilation. Chattagram Maa-O-Shishu Hosp Med Coll J 2016;15(2):9-13. https://doi.org/10.3329/cmoshmcj.v15i2.31796
Kiruthika D, Ramesh P, Bhuvaneshwari CY, et al. Profile and outcome of neonates requiring mechanical ventilation. Medica Innov 2017;6(2):46-49.
Ralser E, Griesmaier E, Neubauer V, Gnigler M, Höck M, Kiechl-Kohlendorfer
U. Readmission of preterm infants less than 32 weeks gestation into early childhood: Does gender difference still play a role? Glob Paediatr Health 2014;1(11):1-6. https://doi.org/10.1177/2333794X14549621
Jahan N, Nasrin M, Haque ZSM, et al. Indication, and short-term outcome of mechanical ventilation in neonates in a tertiary care hospital. Bangladesh J Med Sci 2017;16(1):24-28. https://doi.org/10.3329/bjms. v16i1.31128
Smith CV, Zupancic JA, McCormick MC, et al. Rehospitalisation in the first year of life among infants with bronchopulmonary dysplasia. J Pediatr 2004; 144(6):799-780. https://doi.org/10.1016/j.jpeds.2004.03.026
Lamarchevadel A, Blondel B, Truffert P, et al. Re-hospitalisation in infants younger than 29 weeks’ gestation in the EPIPAGE cohort. Acta Paediatr 2004; 93(10):1340-1345. https://doi.org/10.1080/08035250410032926