Characteristics of Pulmonary Complications Associated with Mechanical Ventilation in Newborns

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 Prevision 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%) atterm infants were admitted. Of those admitted, 135 (86.5%) preterm 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. 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. 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.