ROLE OF MANNITOL IN IMPROVING THE OUTCOMES OF MODERATE TO SEVERE PERINATAL ASPHYXIA

Background: Birth asphyxia, defined as inadequate oxygen supply to a newborn during delivery, is a major cause of neonatal morbidity and mortality, second only to sepsis. While its incidence in developed countries ranges from 1% to 1.5% of live births, it rises significantly in developing nations, reaching up to 5%. Effective management of moderate to severe birth asphyxia remains a challenge. This study evaluates the efficacy of Mannitol infusion in improving survival outcomes in neonates diagnosed with moderate to severe perinatal asphyxia. Objective: To assess the effectiveness of Mannitol in managing cases of moderate to severe perinatal asphyxia in full-term neonates. Study Design: Case series study. Setting: Department of Pediatrics Medicine, Sughra Shafi Medical Complex, Narowal. Duration of Study: March 2, 2023, to September 1, 2023. Methods: A total of 141 full-term neonates diagnosed with moderate to severe perinatal asphyxia were included using consecutive non-probability sampling. Mannitol 20% was administered intravenously at a dosage of 1.5 mL/kg over 20 minutes every 8 hours. All neonates received standard supportive treatment according to established neonatal care protocols. The primary outcome measure was survival or mortality. Data were analyzed using SPSS version 25.0, and post-stratification analysis was conducted using the Chi-square test, with statistical significance set at p ≤ 0.05. Results: Among the 141 neonates, 91 (64.5%) were males and 50 (35.5%) were females. The mean age was 16.35 ± 6.534 days. Mannitol therapy resulted in a survival rate of 82.3% (116 neonates), while mortality was observed in 17.7% (25 neonates). Conclusion: Mannitol infusion demonstrated promising effectiveness in the management of moderate to severe perinatal asphyxia, significantly improving survival rates. These findings support the potential role of Mannitol as a therapeutic option in neonatal intensive care settings, warranting further large-scale studies to validate its efficacy and safety.