Study on effect of duration of mechanical ventilation on retinopathy of prematurity in low birth weight neonates admitted to neonatal intensive care unit
Keywords:Low birth weight neonates, Mechanical ventilation, Retinopathy of prematurity
Background: There has been an increase in morbidity in low birth weight infants, since the advancement in field of neonatology. Various resuscitation methods and life saving interventions are associated with adverse effects. One such intervention is mechanical ventilation and if prolonged, it is known to cause various morbidities like bronchopulmonary dysplasia, retinopathy of prematurity, vocal cord injury. In this study we are considering the effect of duration of ventilation on retinopathy of prematurity.
Methods: This study is a prospective study, an observational study. The study was conducted in Kempegowda Institute of Medical Sciences, Bangalore. Total of 60 low birth weight infants (<2500gm) who were admitted to the Neonatal Intensive Care Unit (NICU) and were on mechanical ventilator support were included in the study. The study was conducted for a duration of 18 months, between January 2019 to June 2020.
Results: Retinopathy of prematurity (ROP) was seen in 19 cases and was the most common complication associated with increasing duration of mechanical ventilation, which accounted for 48% of total complications, followed by abnormal otoacoustic emission (OAE) 17.95%, pneumothorax 10.26%, apnea 7.69%, pneumonia and bronchopulmonary dysplasia 5.13% and Hypoxic ischaemic encephalopathy (HIE) and seizures 2.46%.
Conclusions: In this study, we were able to know the common complications involved in prolonged mechanical ventilation. This provides us to think about needs for measures to reduce the duration of mechanical ventilation and thereby reducing morbidities associated with it.
Lemons JA, Bauer CR, Oh W, Korones SB, Papile LA, Stoll BJ et al. Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network. Pediatr. 2001;107(1):2-8.
Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR, et al. Trends in neonatal morbidity and mortality for very low birth weight infants. Am J Obstet Gynecol. 2007;196((2):147.e1e8.
Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Res Network. Pediatr. 2010;126(3):443e56.
Singh M. Disorders of weight and gestation. Care of the newborn. 8th ed. New Delhi: CBS publishers and distributors. 2015;8:301.
Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA, et al. Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009. Pediatr. 2012;129(6):1019-26.
Smith LJ, Mckay KO, Van Asperen PP, Selvadurai H and Fitzgerald DA. Normal development of the lung and premature birth. Paediatr Respir Rev. 2010;11(3):135e42.
Northway Jr WH, Rosan RC, Porter DY. Pulmonary disease following respiratory therapy of hyaline-membrane disease.Bronchopulmonary dysplasia. N Engl J Med. 1967;276(7):357-68.
Sant’Anna GM, Keszler M. Weaning infants from mechanical ventilation. Clin Perinatol. 2012;39(3):543-62.
Ehrenkranz R, Walsh M, Vohr B, Jobe A, Wright L, Fanaroff A, et al. Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia. Pediatr. 2005;116(6):1353-60.
Walsh MC, Morris BH, Wrage LA, Vohr BR, Poole WK, Tyson JE, et al. Extremely low birth weight neonates with protracted ventilation: mortality and 18 month neurodevelopmental outcomes. J Pediatr. 2005;146(6):798-804.
Deborah K. VanderVeen and John A. F. Zupancic. Chapter 64 Retinopathy of prematurity. Eichenwald, E, Hansen A, Martin C. and Stark A. 2012. Cloherty and Stark's Manual Of Neonatal Care. 7th ed. Philadelphia: Wolters Kluwer. 2012;p.840.
Deborah K. VanderVeen and John A. F. Zupancic. Chapter 64 Retinopathy of prematurity Eichenwald, E., Hansen, A., Martin, C. and Stark, A., 2012. Cloherty And Stark's Manual Of Neonatal Care. 7th ed. Philadelphia: Wolters Kluwer, p.841.
Singh, M. 2015. Chapter 26: Miscellaneous conditions. Care of the newborn. 8th ed. New Delhi: CBS publishers and distributors, p.534.
Deborah K. VanderVeen and John A. F. Zupancic. Chapter 64 Retinopathy of prematurity. Eichenwald E, Hansen A, Martin C. and Stark A, Cloherty And Stark's Manual Of Neonatal Care. 7th ed. Philadelphia: Wolters Kluwer. 2012. p.844.
Fischer HS, Bührer C. Avoiding endotracheal ventilation to prevent bronchopulmonary dysplasia: a meta-analysis. Pediatr. 2013;132(5):e1351-60.