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Associated Ventilation with Mechanical Aids in Newborn Infants.

Journal of the Korean Pediatric Society 1985;28(5):435-447.
Published online May 31, 1985.
Associated Ventilation with Mechanical Aids in Newborn Infants.
Eue Cho Yang, Jung Hwan Choi, Chong Ku Yun
Department of Pediatrics, College of Medicine, Seoul National University
기 계적 보조환기법에 의한 신생아호흡집중치료에 관한 고찰
양의조, 최중환, 윤종구
서울대학교 의과대학 소아과학교실
Abstract
Clinical features of 85 neonates who treated with assisted ventilation in Neonatal Intensive Care Unit at Seoul National University Hospital from April ’80 to Dec. 5 84 were analyzed with special respect to mechanical aids. The results were as follows; 1)According to diagnostic categories, 56 cases (66%) were hyaline membrane disease (HMD), 14 cases (16%) were postasphyxia syndrome (PAS), 9 cases (ll%)were apnea of prematurity, 2 cases (2%) were sepsis and 4 cases (5%) were others. 2)72 cases (85%) were born at SNUH and others were born elsewhere, Male to female ratio was about 2 - 1. 3)Low birth weight infants below 2,500 gm were 63 cases (74%), below 1,500 gm wer& 32 cases (37%) and below 999 gm were 12 cases (14%). Infants below 37 weeks of gestational age were 60 cases (71%) and below 28 weeks were 14 cases (17%). Infants who had asphyxia at birth were 74 cases (87%). 4)According to selected modes of assisted ventilation with mechanical aids, CPAP were used in 45 cases (53%) and IPPB were in 73 cases (84%). Infants who were for the first time given assisted ventilation with in 24 hours of age were 77 cases(87%), and at above 24 hours of age 8 cases (13%). Infants who were given assisted ventilation for below 24 hours were 30 cases (35%), 1 to 3 days 28 cases (33%), 3 to 5 days 14 cases (16%), 5 to 7 days 6 cases(7%), and above 7 days 7 cases (9%). 5)Major complications during respiratory intensive care were pulmonary air leaks(9cases), central nervous system hemorrhage (9 cases), mechanical failure (5 cases), retrolental fibroplasia (3 cases), bronchopulmonary dysplasia (3 cases) and gastrointestinal complication. (1 cases). 6)Total survival rate was 36.4%. For each diagnostic category, the survival rates were: HMD 35.7%, PAS 35.7%, apnea of prematurity 44.4%, sepsis 100% and others 50%. In HMD, survivors had greater birth weight, longer gestational age, better 1 minute Apgar score, older age at the start of assisted ventilation and longer duration of assisted ventilation than non-survivors. In PAS, survivors had better 1 minute Apgar score. In apnea of prematurity, survivors had better 1 minute Apgar score and longer gestational age.
Key Words: Neonate, Assisted ventilation with mechanical aids, Hyaline membrane disease, Postasphyxia syndrome, Apnea of prematurity, Sepsis, CPAP


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