Pulmonary hemorrhage in very low‐birthweight infants: Risk factors and management

Chen, Yingyao; Wang, Hsiao-Ping; Lin, Shu-Ming; Chang, Jenn-Tzong; Hsieh, Kai‐Sheng; Huang, Fu-Kuei; Chiou, Yee-Hsuan; Huang, Ya-Ling

doi:10.1111/j.1442-200x.2012.03670.x

Cited by 25 publications

(16 citation statements)

References 12 publications

(16 reference statements)

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“…After SR, the horizontal left to right shunt of the catheter will increase, and the pulmonary blood flow will increase rapidly, leading to high flow and high-pressure vascular bed injury, which is related to the occurrence of PH [7] . A recent summary also suggests that early indomethacin closure of PDA (3-12h postnatal) can reduce the incidence of PH in preterm infants at 30 weeks of gestational age [8] . In this study, it was shown that the incidence of PDA in group A treated with PS within 3 hours was significantly lower than that in group B, which made the incidence of PH in group A lower than that in group B despite the low birth weight.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

Han

Shuai

et al. 2019

Preprint

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Background: Mechanical ventilation joint PS replacement therapy is an effective method in treatment of NRDS recognized, PS treatment of children with early can improve the oxygenation by increasing gas exchange area, but before FiO 2 to reduce the application of PS can cause local and/or systemic hemodynamic changes, making the use of PS has some potential problems, such as increasing the incidence of the IVH, PH, PDA and so on. SR rescue therapy can be divided into early treatment and delayed treatment, but the specific boundary point of the appropriate time period has not been clear. This paper aims to compare the efficacy differences of PS administration at different time periods and provide basis for the selection of clinical application period of PS. Methods: Case-control study . 135 children diagnosed with NRDS in neonatology department of our hospital. The patients were divided into two groups according to the use time of PS. Group A was applied within 3 hours after birth, and group B was applied 3 hours after birth. The changes of blood gas analysis parameter，mechanical ventilation time, incidence of complications, hospital stay and mortality were compared between the two groups. Results : The decrease of blood gas PaCO 2 in group A before and after treatment was more significant than that of group B (P<0.05), but the improvement of PaO 2 and OI in group B was better than that in group A (P<0.05). Although there were significant differences in birth weight between the two groups, there were no significant differences in the total duration of mechanical ventilation and mortality (P>0.05). Except PDA and BPD, there was no significant difference in the incidence of common complications between the two groups. Conclusion: PS treatment within 3 hours after birth can better improve ventilation, reduce the incidence of PDA. It can also help to reduce the death rate of high-risk children and the total duration of mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

Han

Shuai

et al. 2019

Preprint

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“…This suggests that using epinephrine spraying through an ET is an effective therapy to treat pulmonary hemorrhage. 14 We replaced conventional mechanical ventilation with HFOV in 14 out of the 18 patients as a result of hypoxemia and/or persistent respiratory acidosis. Generally, HFOV is considered less effective in an obstructive lung condition like a pulmonary hemorrhage, and few preliminary studies aimed at analyzing the effect of HFOV in respiratory distress secondary to pulmonary hemorrhage in VLBW infants have been conducted.…”

Section: Discussionmentioning

confidence: 99%

Short-term Outcome of Pulmonary Hemorrhage in Very-Low-Birth-Weight Preterm Infants

Yen

Wang

Hsieh

et al. 2013

Pediatrics & Neonatology

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“…Logistic regression analysis showed that EOS could increase the risk of The incidence of PH is significantly higher in ELBWIs than that in other neonatal populations, and the precise etiology remains unclear. A 10-year retrospective study has shown that the rate of PH in VLBWIs is 4% [3]. Another study reported that the rate of PH was approximately 8% in VLBWIs but was 11-16.6% in ELBWIs [2,9].…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of newborns [1], especially in extremely lowbirth-weight infants (ELBWIs) who are vulnerable to conditions that require invasive ventilation and intensive care after birth. The incidence of clinical PH is estimated to be 1-12 per 1000 live births [2], whereas the rate of PH in very-lowbirth-weight infants (VLBWIs) varies from 4-12% [1][2][3][4]. The variation in its incidence is mainly due to the unclear etiology and diagnostic criteria of PH.…”

Section: Introductionmentioning

confidence: 99%

“…Usually, infants with PH need aggressive positive pressure ventilation, high oxygen supplementation, critical circulatory support and blood transfusions. Asphyxia, prematurity, intrauterine growth restriction, infection, hypoxia and coagulopathy are considered as perinatal risk factors for PH in many studies [1,3,6]. A few case reports have indicated that healthy term infants with PH are associated with inborn errors of metabolism.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal risk factors for pulmonary hemorrhage in extremely low-birth-weight infants

et al. 2019

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Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs). However, the risk factors for PH are controversial. Therefore, the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs. Methods This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g, lived for at least 12 hours, and did not have major congenital anomalies. A logistic regression model was established to analyze the risk factors associated with PH. Results There were 168 ELBWIs born during this period. A total of 160 infants were included, and 30 infants were diagnosed with PH. Risk factors including gestational age, small for gestational age, intubation in the delivery room, surfactant in the delivery room, repeated use of surfactant, higher FiO 2 during the first day, invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis. In the logistic regression model, EOS was found to be an independent risk factor for PH. The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH. The rates of periventricular leukomalacia, moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity, and the duration of the hospital stay were not significantly different between the PH and no-PH groups. Conclusions Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia, it increased the mortality and intraventricular hemorrhage rate in ELBWIs. EOS was the independent risk factor for PH in ELBWIs.

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Pulmonary hemorrhage in very low‐birthweight infants: Risk factors and management

Cited by 25 publications

References 12 publications

Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

Short-term Outcome of Pulmonary Hemorrhage in Very-Low-Birth-Weight Preterm Infants

Perinatal risk factors for pulmonary hemorrhage in extremely low-birth-weight infants

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