Guidelines: Pulmonary hemorrhage is an acute event with bloody fluid noted in the respiratory tract. There can be blood from the nares, mouth and in the endotracheal tube/trachea. It can occur in preterm and term infants, and considered in neonates with a sudden deterioration with clinical pallor, cyanosis, bradycardia or apnea. Pulmonary hemorrhage occurs most commonly in the first few days of life and can have a mortality rate up to fifty percent. Therapies for patients with suspected or confirmed pulmonary hemorrhage can consist of:
Lipid infusion is an integral part of neonatal parenteral nutrition. In its absence, essential fatty acid deficiency can result as early as 3 days after birth. Triglyceride values are followed to monitor lipid tolerance. Acceptable values range between 150 and 200 mg/dL (1.7 and 2.3 mmol/L). This case of hypertriglyceridemia resulting from rapid lipid infusion in an extremely low-birthweight infant demonstrates a rapid decrease in the triglyceride concentration with no intervention. None of the common adverse effects of hypertriglyceridemia were noted. The case also highlights the importance of correctly positioning and regularly evaluating infusion pump tubing to assure the correct rate of lipid infusion.
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