Pulmonary haemorrhage in neonates: Systematic review of management

Barnes, Melissa E.; Feeney, Emily; Duncan, Andrew; Jassim, Samher; MacNamara, Honora; O'Hara, Joseph; Refila, Beshoy; Allen, John A.; McCollum, Danielle; Meehan, Judith; Mullaly, Rachel; O’Cathain, Niamh; Roche, Edna; Molloy, Eleanor J.

doi:10.1111/apa.16127

Cited by 14 publications

(19 citation statements)

References 23 publications

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“…It was noted that was not responsive to therapy, hence it is mostly preventable and ominous. Pulmonary hemorrhage in ventilated neonates can occur as a result of ventilation being initiated due to underlying respiratory problems (respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), and bronchopneumonia), particularly if associated with thrombocytopenia requiring platelet transfusion, and it is recommended to increase positive endexpiratory pressure (PEEP) in intermittent positive pressure ventilation (IPPV) or better to use high-frequency oscillatory ventilation (HFOV) (17).…”

Section: Discussionmentioning

confidence: 99%

Thrombocytopenia is more Frequent in Gram negative Neonatal Septicemia

Alazem

Ghany

Zaky³

et al. 2022

Pediatric Sciences Journal

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Background:Sepsis is one of the major causes of neonatal thrombocytopenia. Aim of the work:To identify the frequency, severity, and clinical outcome of thrombocytopenia associated with culture-proven neonatal septicemia in the Neonatal Intensive Care Units (NICUs) of Cairo University Children's Hospitals. Methods: We conducted a retrospective cohort study that included all neonates with cultureproven sepsis and thrombocytopenia who were admitted to the NICUs over a one-year period (from January 2017 to December 2017). Thrombocytopenia was defined as platelet count less than 150x10 3 /µL. The thrombocytopenic neonates were divided into two groups according to the type of cultured bacteria (gram-positive and gram-negative). Both groups were compared regarding maternal and neonatal risk factors, onset and severity of thrombocytopenia, complications, and patient survival. Results: A total of 316 out of 2172 (total number of NICU admissions) newborns were found to have culture proven-sepsis (14.5%). The frequency of thrombocytopenia in neonates with culture proven-sepsis was 30.3% (n = 96/316). Prematurity is a risk factor for early onset sepsis with thrombocytopenia (p= 0.001). The frequency of severe thrombocytopenia is more in gramnegative sepsis than that in gram-positive sepsis at the onset of sepsis and at the lowest platelet count (p= 0.014, 0.015) respectively. The frequency of hemorrhage in neonates with sepsis and thrombocytopenia was 20.8 % (n = 20/96) and it was mainly pulmonary hemorrhage 10.4 % (n=10). The overall mortality among the study group was 40.6% (n=39/96), with a higher mortality rate (46.3%) in gram-negative sepsis with thrombocytopenia (OR 2.65, p= 0.042). Conclusion: Neonatal thrombocytopenia is a common finding in neonatal sepsis, and the frequency of severe thrombocytopenia is more in gram negative sepsis. Pulmonary hemorrhage is a common type of bleeding in thrombocytopenic neonates with sepsis. Gram-positive sepsis associated thrombocytopenia has a better prognosis than gram-negative sepsis.

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Section: Discussionmentioning

confidence: 99%

Thrombocytopenia is more Frequent in Gram negative Neonatal Septicemia

Alazem

Ghany

Zaky³

et al. 2022

Pediatric Sciences Journal

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“…Intracranial hemorrhage stipulated a head CT or MRI scan or ultrasonogram that showed intracranial hemorrhage. Pulmonary hemorrhage (PH) is lungs’ angiorrhexis caused by an increased pressure on the capillaries of the alveolar wall due to a variety of factors, and the blood enters the lung tissue, which is characterized by sudden onset of frothy, pink-tinged secretions or discharge of bloody fluid from the upper respiratory tract or the endotracheal tube [ 22 ]. The present study protocol was approved by our Hospital Ethics Committee.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Bronchopulmonary Dysplasia in 625 Neonates with Respiratory Distress Syndrome

Tao,

Han,

Guo

2022

Journal of Tropical Pediatrics

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Objective This study was designed to investigate the predictors of bronchopulmonary dysplasia in neonates with respiratory distress syndrome. Methods This was a single-center retrospective cohort study conducted between 1 January 2015 and 31 December 2020. A total of 625 neonates with respiratory distress syndrome (RDS) were enrolled. Demographic data, clinical presentations, complications and related treatment information were collected and analyzed. We used bivariate and multivariate logistic-regression analyses to determine significant predictors of bronchopulmonary dysplasia (BPD) in RDS neonates. Results In these 625 neonates, 102 (16.3%) of them developed BPD. Bivariate analysis and multivariate logistic-regression analyses revealed that birthweight, gestational age under 32 weeks, duration of oxygen therapy over 10 days, asphyxia, patent ductus arteriosus, transfusion of red blood cells (packed red blood cells) and surfactant use were significantly associated with the development of BPD. Conclusion Birthweight, gestational age <32 weeks, total duration of oxygen therapy >10 days, asphyxia, patent ductus arteriosus, need for red blood cell infusion, and the use of pulmonary surfactant were important predictors of BPD in neonates with RDS.

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“…Pulmonary hemorrhage (PH) is a rare, life-threatening complication in premature infants with respiratory distress syndrome. The incidence of PH is 3 to 11 per 1,000 live births with PH occurring most commonly within the first few days of life (1)(2)(3)(4)(5). PH is typically seen in neonates weighing less than 1500 g, who often have a patent ductus arteriosus (PDA), infection complication, trauma, have been treated with surfactant, and are ventilated (4,6,7).…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of PH is 3 to 11 per 1,000 live births with PH occurring most commonly within the first few days of life (1)(2)(3)(4)(5). PH is typically seen in neonates weighing less than 1500 g, who often have a patent ductus arteriosus (PDA), infection complication, trauma, have been treated with surfactant, and are ventilated (4,6,7). Mortality rates of over 50% have been reported in premature infants (8), and as a result, PH does significantly increase the risk of later pulmonary or neurodevelopmental disabilities among those who survive (9,10).…”

Section: Introductionmentioning

confidence: 99%

“…There are several effective methods of managing PH in neonates, including surfactant, high-frequency oscillatory ventilation (HFOV), epinephrine, coagulopathy management, intermittent positive pressure ventilation, cocaine, and tolazoline (4). However, it remains challenging to diagnose and therapy precisely in refractory or focal PH cases.…”

Section: Introductionmentioning

confidence: 99%

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Ultra-slim flexible bronchoscopy-guided topical hemostatic drugs administration for the management of life-threatening refractory pulmonary hemorrhage in a preterm infant: Case report

Lin

Zhao²,

Xue³

et al. 2022

Front. Pediatr.

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Pulmonary hemorrhage (PH) is a rare acute catastrophic event with high mortality among neonates, especially preterm infants. Primary treatments included pulmonary surfactant, high-frequency oscillatory ventilation, epinephrine, coagulopathy management, and intermittent positive pressure ventilation. However, there are still challenges in diagnosing and treating refractory or focal pulmonary hemorrhages. Ultra-slim bronchoscopy has been widely used in the field of critically ill children and is increasingly being done in neonates with critical respiratory disease in recent years. In this study, we report a case with refractory pulmonary hemorrhage in premature infants, which was finally diagnosed as localized hemorrhage in the upper left lobe and cured by ultra-slim bronchoscopy-guided topical hemostatic drug administration. Bronchoscopy is an optional, safe, and practicable technique for early diagnosis and direct injection therapy of neonatal PH in managing life-threatening PH.

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Pulmonary haemorrhage in neonates: Systematic review of management

Cited by 14 publications

References 23 publications

Thrombocytopenia is more Frequent in Gram negative Neonatal Septicemia

Thrombocytopenia is more Frequent in Gram negative Neonatal Septicemia

Predictors of Bronchopulmonary Dysplasia in 625 Neonates with Respiratory Distress Syndrome

Ultra-slim flexible bronchoscopy-guided topical hemostatic drugs administration for the management of life-threatening refractory pulmonary hemorrhage in a preterm infant: Case report

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