الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Several different methods for respiratory support can be applied in the care of individual neonates. These methods include oxygen therapy, CPAP, invasive mechanical ventilation. Adequate tissue oxygenation maintenance is one of the primary goals of therapy during respiratory support. Continuous positive airway pressure (CPAP) has become a standard part of ventilatory care. It is believed to progress alveolar recruitment, inflate collapsed alveoli, and reduce intrapulmonary shunt. Application of CPAP appears to produce a more regular breathing pattern in preterm neonates and has been thought to be mediated through chest-wall stabilization and reduction of thoracic distortion. The introduction of invasive ventilation for neonatal pulmonary insufficiency has resulted in the successful treatment of many previously fatal diseases. In addition, the refinement of mechanical ventilation during the past three decades has dramatically improved survival of many high-risk neonates. This study was conducted on 100 neonates admitted to NICU, Pediatrics Department of Sohag University Hospital during one-year period with age of 0-28 days with symptoms of respiratory distress (tachypnea, intercostal and subcostal retractions, nasal flaring and grunting) that evident shortly after birth and requiring respiratory support. All the neonates included in the study were subjected to prenatal history,natal history,postnatal history ,ventilatory support,duration of hospital stay and outcome(survival, death).The total number of admissions in NICU over one year was 500,one
hundred newborn infants were included in the study with gestational age ranged from 27 to 40 weeks and birth weight ranged from 600 to 4400 gm Respiratory distress was present in all patients. The most common cause of admission was RDS (50%), sepsis (38%), asphyxia (8%) and pneumonia (4%).Seventy two % of the studied patients underwent CPAP, 14% oxygen support by nasal cannula and 14% mechanical ventilation. We used oxygen with full-term and near-term neonates with tachypnea, used nasal CPAP with all preterm neonates with recurrent apneas or early features of RDS and those who had a failure of nasal CPAP therapy or had respiratory acidosis were ventilated. Eighty two (82%) of patients put on CPAP had improved and the failure rate of CPAP therapy was 18%. This failure rate in our study is attributed to late presentation, sepsis and poor resources in our country. Fourteen (14%) of cases included in our study need mechanical ventilation Adverse effects had occurred in 6 (42%) of them as: pneumothorax,ventilation acquired pneumonia and pulmonary hemorrhage. Mortality rate in ventilated babies in this work was 42.9%. CPAP is the most widely used modality of non-invasive respiratory support and there are different devices and ways of delivering CPAP in practice. Identification of risk of fatality in ventilated neonates is compulsory in order to intervene early, decrease the mortality, and even for triage in resource limited settings. Among the numerous commonly available variables studied by us, weight <2500 g, gestation <34 weeks, and recurrent apnea were significant predictors of mortality in ventilated neonates.