Outcome and associated factors of mechanically ventilated Neonates among selected hospitals in Addis Ababa, Ethiopia; Cross -sectional Multi-center study
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Date
2024-03
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Addis Ababa University
Abstract
Background: Neonatal mortality has a significant impact on global mortality, morbidity,
economic cost, and hospitalization worldwide. Improving neonatal health through innovations in
healthcare, such as mechanical ventilation, is vital for improving the well-being and lowering
mortality rates among newborns. The most common indication for MV in NICUs was respiratory
distress syndrome.
Objective: To assess the outcome and associated factors of mechanically ventilated neonates
admitted in three NICUat selected hospitals in Addis Ababa, Ethiopia 2023
Methods: A cross-sectional study was conducted to examine the outcomes and contributing
factors for mechanically ventilated neonates admitted to Girum Hospital, Addis Hiwot Hospital,
and Myungsung Christian Medical Center (MCM). Three private hospitals were chosen through
a simple random sampling method, where a total of 160 mechanically ventilated neonates were
identified during the study period. A univariate and multivariate binary logistic regression
analysis was performed to examine the factors associated mortality of mechanical ventilated
neonates. The results of logistic regression reported as adjusted odds rations (OR) with 95%
confidence intervals and p-value < 0.05 are considered statistically significant
Results: An analysis of 160 neonates requiring mechanical ventilation that 61.3% were male and
63.7% displayed preterm gestational age. The primary reasons for mechanical ventilation (MV)
in this study was respiratory distress syndrome (RDS) being the most prevalent at 51.9%,
followed by meconium aspiration syndrome (MAS) at 12.5%, and neonatal sepsis at 11.9%. The
overall mortality rate of mechanical ventilated neonates was 24.4%. Moving to associated factors
requirement of resuscitation(AOR=9.9(1.7, 58.5),p=0.011),extreme prematurity
(AOR=61.7(3.3,1150.1),p=0.0006),DIC(AOR=13.1(1.6, 104.5), p=0.015),AKI (AOR=13.1(2.24,
76.9), p=0.004), MOF (AOR=246.9(14.4, 4242.8), p=0.0000) and pulmonary hemorrhage
(AOR=16.7(1.9,145.9), p=0.011) emerged as the most statistically significant variables
determining mortality of neonates on mechanical ventilator
Conclusion: The commonest indication for mechanical ventilation in was RDS. Prematurity and
disease-related complications were among the preventable factors contributing to mortality.
Although the mortality rate of mechanically ventilated neonates is lower compared to similar
studies in low and middle-income countries,.
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Keywords
Neonatal Mortality, mechanically ventilated, Neonates