Objective: Mechanical ventilation, one of the life saving mode of therapy, decreases morbidity and mortality in neonates, and serves to support adequate ventilation and oxygenation. We aimed to define the neonates, indications, complications and mortality due to mechanical ventilation.

Method: We investigated the hospital records of the newborns hospitalized in our neonatal intensive care unit between 1 January 2006 / 31 December 2006. Mechanically ventilated neonates were included in this study.

Results: There were 1148 neonates hospitalized over a year study period and 73 of them (6.4%) were included in this study. The ratios of female/male, term/preterm, cesarean/vaginal deliveries were 33/40, 30/43, and 29/44 respectively. The mean birth weight was 2326.3±885.5 g (530-3800 g), postnatal age was 6.5±11 days (0-60 days), gestational age was 35±4.5 weeks (24-42 weeks), 5th minute Apgar score was 6.3±2.8 , Clinical Risk İndeks Scor of Babies (CRIB) score on admission was 5.12±2.96 , mechanical ventilation time was 7.6±7.5 days (1-35 days). The number of neonates transported to our unit was 50 (68.5%). Only 4 of these babies were ventilated by positive pressure ventilation via endotrakeal entubation during the transport. Endications to mechanical ventilation were neonatal pneumonia (24.7%), respiratory distress syndrome and/or prematurity related disorders (21.9%), sepsis (11%) and perinatal asphyxia (13.7%). The ratio of complications was 27.4%, and these were atelectasis (15.1%), nosocomial pneumonia (13.7%), pulmonary haemorrhage (9.5%), pneumotorax (6.8%). The ratio of mortality was 42.5% (n=31), especially in the infants of premature births and major congenital anomalies. We found significant relation between mortality and CRIB score on admission (p=0.014), 5th minute Apgar score (p<0.0001), pulmonary hypertension (p=0.04), congenital heart disease (p<0.0001), perinatal asphyxia (p=0.05), duration of mechanical ventilation (p=0.03), and transportation (p=0.001). There was no relation between complication and mortality (p>0.05).

Conclusion: Mechanical ventilation is a life saving way of therapy for the neonates. On the other hand, improvement of mortality and morbidity should not be expectate, if there is a delay in the initiation of mechanical ventilation, not to ventilate the babies with insufficient respiration during transportation, not to support these babies under optimal conditions and concurrently by trained health care proffessionals during the application of mechanical ventilation. The mortality, morbidity, and complications of mechanical ventilation in neonates should be decreased by applying appropriate and early support by trained health care proffessionals concurrently, especially without cessation during transport of baby to another hospital, aseptic and minimal invasive procedures in the unit

Keywords: Complication, indication, mechanical ventilation, newborn, outcome