Mechanical Ventilation Treatment Outcome and Associated Factors Among Neonates at Ababa, Ethiopia, 2023

Abstract

Abstract Introduction: Mechanical ventilation is an important intervention for critically ill neonates in intensive care. Supporting gas exchange while minimizing harm is the key therapeutic goal, despite that mechanical ventilation is associated with complications. In Ethiopia there is no prior study regarding mechanical ventilator treatment outcome in neonates. Objectives: To assess mechanical ventilation treatment outcome and associated factors among neonates in selected hospitals at Addis Ababa, Ethiopia. Methods: A cross-section study design with retrospective data collection of a six-year data collected from March to May,2023 among all 260 mechanically ventilated neonates. The patient's medical record number was used to select the patients. Trained data collectors extracted the data from neonatal charts using a pretested data extraction checklist. The data had been loaded to SPSS 21 for analysis. As bivariate and multivariate measures, the crude odd ratio (COR) and adjusted odd ratio (AOR) were used to assess the degree of relationship between the independent and dependent variables at p-value less than 0.05. Then the findings had been presented as graphs, tables, and text. Result: Among mechanically ventilated neonates, 134(51.5%) were male, (49.6%) low birth weight, and (51.5%) were preterm. The main reasons for ventilation were respiratory distress syndrome (97.7%), Sepsis (56.9%), Perinatal asphyxia (28.1%), and Meconium aspiration syndrome (21.2%). The median duration of stay on the ventilator was 48 hours with interquartile range (IR2). 26(17%) developed complication, major complication was pulmonary hemorrhage (7.7%), 19(7.3%) hospital acquired infection and 12(4.6%) ventilator associated pneumonia. The mortality rate was 99(38.1%), cardiopulmonary resuscitation at birth, sepsis, pulmonary hemorrhage, congenital heart disease, and shock on mechanical ventilation statistically significantly associated to death among neonates on mechanical ventilation for the respective AOR with (95% CI). Conclusion and recommendation: Mechanical ventilation poor treatment outcome is a public health problem. Majority of the mechanically ventilated neonates were preterm thus focus should be given for preterm mechanical ventilator treatment. Keywords: Neonate, Mechanical ventilation, Poor outcome, Ethiopia