Predictors of Mortality among Ventilated Young Infants in Intensive Care Unit of a Tertiary Care Hospital

Abstract

Introduction: The management of children with invasive ventilation in developing countries with limited resources is challenging. A large number of infants in intensive care unit require mechanical ventilation due to various conditions and have a high mortality. Aim of the study: To identify the predictors of mortality among ventilated young infant up to 2 months age in Intensive Care Unit of Bangladesh Shishu Hospital & Institute. Methodology: The prospective observational study was conducted in the Department of Intensive Care Unit of Bangladesh Shishu Hospital & Institute, from January 2020 to December 2020. Critically ill young infants upto 2 months age who required mechanical ventilation in Intensive Care Unit were included in this study. Data was collected on a structured proforma and included the basic demographic profile, presenting complaints, preliminary diagnosis, investigation results, mode of ventilation and initial ventilator parameters & hospital stay and outcome. Permission from ethical review committee of the hospital was taken. Results: From 50 critically ill patients, mortality rate was 74.0%. Mean age was 14±10.1 days. Significant relation was found between the ventilated patients having FiO2, PIP, PEEP, HCO3, BE, serum sodium level, duration of ventilation and outcome respectively. Severe respiratory distress before death was found significantly related with outcome. Metabolic acidosis was found significant in death patients before ventilation and before death (75.7% & 51.4%). Conclusion: The rate of mortality in the ICU was high. Initial high PIP, low HCO3, severe respiratory distress and prolong duration of ventilation (>5days) were significant independent predictors of mortality.