Applying of mechanical ventilation in Newborns

Uvod: Mehanička je ventilacija metoda liječenja koja se koristi kod razvoja dišne patnje novorođenčeta. Najčešći su uzroci dišne patnje terminskog novorođenčeta: sepsa, MAS, TTN, strukturne abnormalnosti i perinatalna asfiksija. Ustroj studije: Povijesna kohortna studija. Cilj je opisati rizične čimbenike (od strane majke, od strane novorođenčeta i u samome porodu), uzroke dišne patnje te neonatalni ishod terminske novorođenčadi koja je bila podvrgnuta mehaničkoj respiratornoj potpori kao i istražiti postoje li promjene u istima tijekom tri promatrana jednogodišnja razdoblja. Ispitanici su bila terminska novorođenčad na mehaničkoj ventilaciji u trogodišnjem razdoblju – od 1. siječnja 2017. do 31. prosinca 2019. godine. Rezultati su prikazani u tablicama, apsolutnim i relativnim frekvencijama, a značajnost razlika hi-kvadrat testom s 95-postotnim intervalom pouzdanosti (P < 0,05). Rezultati: Uočen je trogodišnji porast u broju majki bez osobitosti u reproduktivnoj anamnezi kao i porast u broju poroda bez komplikacija. Daleko su najčešći uzroci dišne patnje, u svim razdobljima, bile sepsa i aspiracija. Kroz godine se bilježi porast u broju novorođenčadi bez popratnih bolesti ili simptoma uz osnovni uzrok dišne patnje, ali je u godini 2017. višestruko veći broj novorođenčadi sa žuticom i onih s ostalim, rjeđim, manama nego u naredne dvije godine. Smanjila se potreba za invazivnom mehaničkom ventilacijom kod sepse i aspiracije. Tijekom godina smanjena je administracija surfaktanta u ventilirane novorođenčadi. Zaključak: Boljom su perinatalnom skrbi smanjeni broj i utjecaj rizičnih čimbenika za nastanak dišne patnje, a primjenom je neinvazivne mehaničke dišne potpore u novorođenčadi poboljšan neonatalni ishod.Introduction. Mechanical ventilation is a therapy method which is used to treat respiratory distress of a newborn. The most common causes of respiratory distress in term newborns are: sepsis/pneumonia, MAS, TTN, structural abnormalities and perinatal asphyxia. Study design. Historical cohort study. Objective. The goal is to present risk factors by mother, by infant and those presented in delivery, causes of respiratory distress and neonatal outcome of term newborns who were subjected to mechanical ventilation, as well as to explore whether there are changes in the same between the three observed one-year periods. Participants were term infants who were mechanically ventilated during the three-year period – since January 1st 2017 to December 31st 2019. The data were presented in charts, in absolute and relative frequencies and the significance of differences were shown by Chi-square test, resulting in 95 % interval of reliability (P < 0.05). Results. Three-year increase is shown in number of mothers without any peculiarity in reproductive anamnesis and also in number of labors without complications. The most common causes of respiratory distress, in every year, were sepsis and aspiration. There is a rise through the years in number of newborns who had no additional symptoms other than the leading diagnosis that caused respiratory distress, but in year 2017 there is a larger number of infants with jaundice and those in the group of rarer defects than in the next two years. The usage of invasive mechanical ventilation was decreased in sepsis and aspiration. The administration of surfactant in mechanically ventilated patients was decreased through the years. Conclusion. The number and impact of risk factors for respiratory distress has been reduced by better perinatal care, and the neonatal outcome has been improved by the usage of non-invasive mechanical respiratory support in newborns