versão On-line ISSN 1683-9803
CARBALLO-PIRIS DA MOTTA, C; GOMEZ, ME e RECALDE, L. Characteristics of Pulmonary Complications Associated with Mechanical Ventilation in Newborns. Pediatr. (Asunción) [online]. 2010, vol.37, n.2, pp.107-111. ISSN 1683-9803.
Introduction: Mechanical ventilation is an invasive procedure with known risks that must be anticipated and when possible identified early in order to implement immediate treatment. Respiratory complications represent one of those risks. Objective: To analyze pulmonary complications in newborns (NB) that required mechanical ventilation (MAV) during hospitalization in the Neonatal Intensive Care Unit (NICU) at the central hospital of the Instituto de Previsión Social (IPS-HC). Method: A descriptive, retrospective, cross sectional study in the NICU of the HC-IPS from July 2008 to June 2009, with data obtained from delivery room statistical records and those of the Neonatal Intensive Care Unit. Results: 4500 births were recorded. Of the NB, 156 (3.46%) premature and 37 (0.82%) at-term infants were admitted. Of those admitted, 135 (86.5%) pre-term and 33 (89.1%) at-term NB required MAV. Of the 193 NB admitted to the NICU (4.2% of all newborns), 168 (87%) received invasive MAV procedures, with 73 (43%) of those showing pulmonary complications; 22% were aged 25 to 28 weeks, 22% were 28.5 to 31 weeks, 21% were 31.5 to 34 weeks, 21% were 34.5-36.5 weeks, and 14% were from 37.5 to 40 weeks of age. Males predominated, making up 67%.It was found that 50% of NB weighed between 1000g and 2000g, and these, together with those of 2001g-3000g, were those most commonly presenting respiratory complications. Of those, 76.3% were pre-term newborns and 5.7% at term in both groups. Pulmonary complications found were pneumothorax (26/73), atelectasis (26/73), ventilator-associated pneumonia (33/73), bronchopulmonary dysplasia (7/73) interstitial emphysema (7/73), pulmonary hemorrhage (5/73), and pleural effusion, (3/73).Average hospital stay was 11-20 days. Of the NB who required mechanical ventilation and in whom pulmonary complications were found, 75.3% were discharged alive and 24.6% died. Causes of death were, in order of frequency, pneumothorax, ventilator-associated pneumonia and atelectasis. Conclusion: Mechanical ventilation was used in less than half of children born in this period.MAV was successfully applied in a high percentage, but in almost half complications such as ventilator-associated pneumonia, pneumothorax, atelectasis, or interstitial emphysema were observed. All who died were pre-term male newborns weighing less than 2000g. Deaths occurred almost exclusively in the first week of hospitalization due to pneumothorax, ventilator-associated pneumonia, and atelectasis, but not in the same order as their presentation as a complication.
Palavras-chave : Newborn; Respiratory Distress Syndrome; Neonatal Intensive Care Unit; Mechanical Ventilation; Pulmonary Complications; Central Hospital of the Instituto de Previsión Social.