Pulmonary Hemorrhage

Tomaszewska, Maria; Stork, E.K.; Minich, Nori; Friedman, Harriet; Berlin, Sheila C.; Hack, Maureen

doi:10.1001/archpedi.153.7.715

Cited by 55 publications

(10 citation statements)

References 24 publications

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“…The larger the leftto-right shunt, the more association with risk of necrotizing enterocolitis, intraventricular hemorrhage, acute kidney injury and death (7,42,43). Very low birth weight preterm infant survivors of pulmonary hemorrhage were associated with a PDA (79%) in comparison to their controls (55%) (44). Although, this mechanism is not completely understood.…”

Section: Pda In the Premature Neonatementioning

confidence: 97%

Management of Patent Ductus Arteriosus in Premature Infants in 2020

et al. 2021

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The patent ductus arteriosus (PDA) is the most commonly found cardiac condition in neonates. While there have been several studies and thousands of publications on the topic, the decision to treat the PDA is still strongly debated among cardiologists, surgeons, and neonatologists. This is in part due to the shortage of long-term benefits with the interventions studied. Practice variations still exist within sub-specialties and centers. This article briefly summarizes the history, embryology and histology of the PDA. It also succinctly discusses the hemodynamic significance of a PDA which builds the framework to review all the available literature on PDA closure in premature infants, though not a paradigm shift just yet; it introduces transcatheter PDA closure (TCPC) as a possible armament to the clinician for this age-old problem.

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Section: Pda In the Premature Neonatementioning

confidence: 97%

Management of Patent Ductus Arteriosus in Premature Infants in 2020

et al. 2021

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“…Currently, relevant studies on the etiology of neonatal pulmonary hemorrhage are mainly focused on respiratory problems and hemodynamic changes [5] . With respect to respiratory problems, neonatal respiratory diseases such as neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) often require mechanical ventilation therapy to maintain breathing.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing pulmonary hemorrhage in very low-and extremely low-birth-weight infants: a meta-analysis

Shi,

Tao,

et al. 2024

Preprint

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Background Pulmonary hemorrhage is a common complication in preterm infants, especially in very low-and extremely low-birth-weight infants, and has high morbidity and mortality rates. Although some studies have analyzed the epidemiological incidence of pulmonary hemorrhage and related factors, there are discrepancies between the results of these studies due to differences in study populations and study designs. Therefore, we conducted a meta-analysis of the factors affecting pulmonary hemorrhage to provide a reference for early clinical recognition and prevention of pulmonary hemorrhage. Methods Systematic searches of the PubMed, Embase, Cochrane Library and other databases were performed to extract the results of logistic regression analyses of case-control or cohort studies related to the factors affecting pulmonary hemorrhage in very-low and extremely-low-birth-weight infants. The data were analyzed using RevMan 5.3 software. Results A total of 13 studies were included and 11 influencing factors were screened through quantitative integration. All factors were statistically significant except for hypothermia: birth weight (OR=0.75, 95% CI 0.59-0.97, P=0.03, I2=95%), coagulation disorders (OR=4, 95% CI 1.79-8.93, P<0.01, I2=66%), patent ductus arteriosus (OR=3.52, 95% CI 1.71-7.27, P<0.01, I2=80%), mechanical ventilation (OR=2.94, 95% CI 1.94-4.45, P<0.01, I2=0%), aneaemia (OR=5.15, 95% CI 2.92-9.07, P<0.01, I2=43%), 5-min Apgar score (OR=1.6, 95% CI 1.21-2.11, P<0.01, I2=46%), early-onset sepsis (OR=2.71, 95% CI 1.62-4.53, P<0.01, I2=0%), antenatal steroids (OR=0.39, 95% CI 0.21-0.73, P<0.01, I2=25%), preterm birth (OR=1.99, 95% CI 1.34-2.97, P<0.01, I2=47%), and blood product transfusion (OR=6.16, 95% CI 2.15-17.69, P<0.01, I2=0%). Conclusion This study revealed the factors affecting pulmonary hemorrhage in very-low and extremely-low-birth-weight infants, and the results of the meta-analysis will be supplemented by a standardized cohort study based on this study. Trial registration PROSPERO (CRD42023465025)

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“…In our cohort low birth weight, anemia, blood transfusion, apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, sepsis, shock, DIC, and mechanical ventilation were all independent risk factors for PH. According to the literature ( 13 ), bleeding into the lungs occurs mainly in premature newborns with severe lung disease. Risk factors have been proposed to be respiratory problems ( 14 ) and hemodynamically significantly increased blood flow (persistent ductus arteriosus, PDA) in the blood vessels in the lungs ( 15 ), like when sepsis impacts on hemodynamics and reopens or enlarges the patent ductus arteriosus.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hemorrhage and associated risk factors among newborns admitted to a tertiary level neonatal unit in Botswana

Gezmu,

Tefera,

Mochankana

et al. 2023

Front. Pediatr.

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IntroductionPulmonary hemorrhage (PH) is a life-threatening complication seen in very sick newborns with high morbidity and mortality. There is little data on the incidence, risk factors, and ultimate survival of newborns with pulmonary hemorrhage in sub-Saharan countries, where the healthcare provision and facility differ in many ways compared to high-income countries. Hence, this study aimed to determine the incidence, identify the risk factors, and describe the outcome of pulmonary hemorrhage in newborns in a low middle income country setting.Methods and materialsA cohort study with prospective data collection was conducted in a public, tertiary-level hospital in Botswana, the Princess Marina Hospital (PMH). All newborns admitted to the neonatal unit from 1 January 2020 to 31 December 2021 were included in the study. Data were collected using a checklist developed on the RedCap database (https//:ehealth.ub.ac.bw/redcap). The incidence rate of pulmonary hemorrhage was calculated as the number of newborns who had pulmonary hemorrhage per 1,000 newborns in the 2-year period. Group comparisons were made using X2 and Student’s t-tests. Multivariate logistic regression was used to identify risk factors independently associated with pulmonary hemorrhage.ResultThere were 1,350 newborns enrolled during the study period, of which 729 were male newborns (54%). The mean (SD) birth weight was 2,154(±997.5) g, and the gestational age was 34.3 (±4.7) weeks. In addition, 80% of the newborns were delivered in the same facility. The incidence of pulmonary hemorrhage was 54/1,350 {4% [95% CI (3%–5.2%)]} among the newborns admitted to the unit. The mortality rate in those diagnosed with pulmonary hemorrhage was 29/54 (53.7%). Multivariate logistic regression identified birth weight, anemia, sepsis, shock, disseminated intravascular coagulopathy (DIC), apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, mechanical ventilation, and blood transfusion as risk factors independently associated with pulmonary hemorrhage.ConclusionThis cohort study identified a high incidence and mortality rate of pulmonary hemorrhage in newborns in PMH. Multiple risk factors, such as low birth weight, anemia, blood transfusion, apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, sepsis, shock, DIC, and mechanical ventilation, were identified as independently associated risk factors for PH.

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Pulmonary Hemorrhage

Cited by 55 publications

References 24 publications

Management of Patent Ductus Arteriosus in Premature Infants in 2020

Management of Patent Ductus Arteriosus in Premature Infants in 2020

Factors influencing pulmonary hemorrhage in very low-and extremely low-birth-weight infants: a meta-analysis

Pulmonary hemorrhage and associated risk factors among newborns admitted to a tertiary level neonatal unit in Botswana

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