Is hyperventilation a common iatrogenic problem in the neonatal intensive care unit?

Abstract

Background. Mechanical ventilation is a critical intervention in neonatal intensive care units (NICUs), but it has been associated with increased mortality and morbidity, particularly through complications like hyperoxemia and hypocapnia. This study aims to identify the incidence of these conditions in ventilated neonates and correlate them with ventilator parameters and related complications. Materials and methods. This observational study was conducted on 100 neonates who were mechanically ventilated in the NICU of Abo-Rish El Monira Hospital, Cairo University, between March and September 2019. Participants were selected based on their requirement for mechanical ventilation during NICU admission. Data collection included perinatal history, ventilator parameters, and arterial blood gas results. Statistical analyses were performed using Pearson correlation, independent t-tests, and logistic regression analysis. Results. The incidence of hypocapnia was 82 %, while 77 % of neonates experienced arterial hyperoxemia. Hypocapnia was more frequent with prolonged mechanical ventilation, showing a significant positive correlation with the incidence (P 0.05). Mortality rates were higher among neonates with hypocapnia (67.1 %) and hyperoxemia (65 %). Conclusions. Hyperoxemia and hypocapnia are common complications of mechanical ventilation in the NICU settings, with hypocapnia showing a higher incidence. Both conditions are associated with increased mortality, particularly among neonates with lower gestational age and birth weight. Managing ventilator settings and monitoring blood gases are critical in reducing these complications.

Keywords

• hyperventilation
• iatrogenic complications
• neonatal intensive care unit
• hypocapnia
• hyperoxemia