Determine the Factors Associated with High Mortality in Ventilated Neonates

Open Access

Abstract

Introduction: Neonatal mortality remains a major health concern in Bangladesh, particularly among critically ill neonates requiring mechanical ventilation. Understanding the clinical and biochemical factors associated with mortality can guide early interventions and improve outcomes. Methods & Materials: This retrospective observational study included 60 neonates who received invasive mechanical ventilation in the NICU of Dhaka Shishu Hospital, a tertiary care pediatric centre, from June 2007 to March 2008. Data were extracted from hospital records. Univariate analysis was conducted using Chi-square or Fisher’s exact test for categorical variables and t-test or Mann–Whitney U test for continuous variables. Results: Among 60 ventilated neonates, 37 (61.7%) died and 23 (38.3%) survived. Mortality was highest in neonates with gestational age <28 weeks (91.7%) and those admitted to the ICU after >12 hours (64.9%, p=0.01). ABG abnormalities were significant: pH ≤7.1 (83.3% mortality, p=0.003) and base deficit ≤–10 (73.3%, p=0.018). Electrolyte disturbances, including hyponatremia (<130 mmol/L, 87.5%, p=0.03) and hypokalemia (<3.5 mmol/L, 88.2%, p=0.02), were associated with higher mortality. Multivariate logistic regression identified septicemia (OR 219.6, 95% CI 1.15–448.8, p=0.044), RDS & pneumonia (OR 111.3, 95% CI 1.20–138.5, p=0.044), high base deficit (OR 1.79, 95% CI 1.11–2.8, p=0.018), and delayed ICU admission >12 hours (OR 8.29, 95% CI 1.20–23.5, p=0.024) as independent predictors of mortality. Conclusion: Mortality among ventilated neonates is significantly associated with septicemia, respiratory distress, metabolic derangements, and delayed ICU admission. Early identification and management of these factors may improve neonatal outcomes in intensive care settings.