Complications associated with mechanical ventilation in neonates

  Complications associated with mechanical ventilation in neonates
by Dr. M. Tauseef Omer

CategoryComplications
PulmonaryOxygen toxicity
Barotrauma due to excessive pressures
Volutrauma due to excessive volumes
Repeated alveolar collapse and expansion (atelectotrauma)
Increased inflammation (bio trauma)
endotracheal tube trauma (endotrauma)
high or inadequate flow (rheotrauma)
All of these traumas add up in the pathophysiology of Chronic Lung Disease.
Pneumothorax, pulmonary hemorrhage, atelectasis, BPD, VAP

CardiovascularHypotension (high intra thoracic pressures reduce cardiac output, impaired venous return)
Exacerbation of PPHN by poor oxygenation and ventilator settings

NeurologicalIVH due to fluctuations in cerebral blood flow
Neurodevelopmental impairment (mechanical ventilation >21 days is associated with higher risk of cerebral palsy and delayed milestones.

GastrointestinalFeeding intolerance, and oral aversion, NEC (due to altered perfusion and systemic stress)

InfectiousSepsis (endotracheal tube provides a portal for infections)
ventilator-associated pneumonia
Long-Term OutcomesGrowth restriction (due to prolonged illness delayed catch-up growth)

neurocognitive delay (survivors of prolonged ventilation show higher rates of learning difficulties,
high mortality (studies show 40-50% mortality in mechanically ventilated babies in resource limited settings)

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