Abstract: Objective To identify risk factors of pulmonary complications (PPCs) following neonatal necrotizing enterocolitis (NEC). Methods The electronic medical record system data of children diagnosed with NEC who underwent partial enterocolectomy in the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2023 were retrospectively reviewed. According to the occurrence of PPCs in 7 days after surgery, the children were divided into two groups: PPCs group and non-PPCs group. Pre-operative, intra-operative and post-operative data of the children from two groups were collected and statistically analyzed. Risk factors for PPCs were screened out by univariate independent variables, and variables with differences between groups in univariateanalysis were included in multivariate Logistic regression analysis to further determine the risk factors for PPCs in NEC. Results A total of 216 children meeting the criteria were included, of which 86(40%) had PPCs and 130(60%) had no PPCs. The Results of univariate Logistic regression analysis showed that pre-operative low body mass, low gestational age, high American Society Anesthesiologists(ASA)grade, low pre-operative hemoglobin level, intra-operative volume control ventilation, no positive end expiratory pressure(PEEP), intra-operative hypoxemia were correlated with the occurrence of PPCs in the two groups, and the differences were statistically significant(P＜0.05). Through the Results of univariate analysis, collinear variables were corrected, and variables with differences between groups were included in multivariate Logistic regression. It was found that pre-operative low body weight(OR=0.262, 95% CI:0.144-0.447, P＜0.001),intra-operative volume control ventilation(OR=0.471, 95% CI:0.261-0.850, P＜0.05) and intra-operative PEEP(OR=0.064, 95% CI:0.007-0.623, P＜0.05) were identified as risk factors for PPCs in children with NEC. Conclusions Pre-operative low body weight, intra-operative volume control ventilation and non-use of PEEP are independent risk factors for PPCs in children with NEC.

Key words: newborn, necrotizing enterocolitis, ventilation mode, postoperative pulmonary complications