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

Yen, Ting-An; Wang, Ching-Chia; Hsieh, Wu‐Shiun; Chou, Hung-Chieh; Chen, Chien-Yi; Tsao, Po‐Nien

doi:10.1016/j.pedneo.2013.04.005

Cited by 38 publications

(40 citation statements)

References 20 publications

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“…HFOV could be used as an alternative ventilator therapy in cases where conventional mechanical ventilator treatment failed to support the patients with acute respiratory failure. However, HFOV is generally considered to be less effective in treating an obstructive lung condition like a pulmonary hemorrhage . In fact, although HFOV was applied transiently in our case 2, it was not helpful in improving the patient's respiratory conditions.…”

Section: Discussionmentioning

confidence: 68%

Massive pulmonary hemorrhage before living donor liver transplantation in infants

Matsuura

Yoshimaru

Yanagi

et al. 2015

Pediatric Transplantation

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A massive pulmonary hemorrhage in patients with liver cirrhosis is a life-threatening complication that may result in a contraindication of a liver transplantation because of its high mortality rate. Herein, we present two infant biliary atresia cases that successfully underwent an LDLT that was followed by intensive respiratory care for the pretransplant massive pulmonary hemorrhage. Both cases exhibited severe respiratory failure (minimum PaO2/FiO2; 46 mmHg and 39 mmHg, respectively). To arrest the bleeding, we applied a very high positive pressure ventilation treatment (maximum PIP/PEEP; 38/14 cmH2O and 55/15 cmH2O, respectively), plasma exchange, several FFP transfusions, and recombinant factor VIIa via intrapulmonary administration. In addition, we used CHDF treatment, applied HFOV transiently, and treated the patient with inhalation of nitric oxide. Although we prepared ECMO for intra-operative use, both cases were successfully managed with conventional mechanical ventilation without using ECMO, which may have worsened the pulmonary hemorrhage due to the use of an anticoagulant. Use of an excessive positive pressure management, although it poses a risk for barotrauma, could be acceptable to arrest the pulmonary bleeding in selected cases of liver failure patients who have no time remaining before LDLT.

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Section: Discussionmentioning

confidence: 68%

Massive pulmonary hemorrhage before living donor liver transplantation in infants

Matsuura

Yoshimaru

Yanagi

et al. 2015

Pediatric Transplantation

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“…Both PH and intraventricular hemorrhage are related to perinatal hemodynamic instability [13]. The effective management of PH includes positive pressure ventilation [4], blood transfusion and circulation support. However, there were no significant differences in mechanical ventilation, oxygen supplementation, or hospital stay between surviving infants in the PH and no-PH groups, mainly because these factors, in addition to PH, are independently related to prematurity.…”

Section: Discussionmentioning

confidence: 99%

“…PH was defined as bright red blood secretion from the endotracheal tube that was associated with clinical deterioration, including increased ventilator support with a fraction of inspired oxygen (FiO 2 ) increase of > 0.3 from the baseline [1] or an acute drop in hematocrit (> 10%) [4], in addition to multilobular infiltrates on chest radiography. The record of ventilation of every infant was reviewed by two attending neonatologists independently and confirmed the diagnosis of PH.…”

Section: Methodsmentioning

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%

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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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“…Pulmoner kanama risk faktörleri asfiksi, doğum odasında resusitasyon, eksik antenatal steroid [5,6], düşük gestasyonel yaş ve hafta, patent duktus arteriorus (PDA), enfeksiyon ve surfaktan tedavisidir [7,8]. Pulmoner kanama tedavisinde endotrakeal yol ile adrenalin ve yüksek frekanslı ventilasyon uygulanmaktadır [9]. Pulmoner kanama sonrası ortamdaki hemoglobin, lipit ve protein surfaktan yetersizliğine neden olarak yüzey gerilimini arttırmakta ve ikincil respiratuar distres sendromu (RDS) gelişmektedir [10].…”

Section: Introductionunclassified

Prematüre yenidoğanlarda pulmoner kanama risk faktörleri

Özalkaya

Karatepe

Topçuoğlu

et al. 2015

ZKTB

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Bu çalışmada Ocak 2012 ile Ocak 2015 arasında yenidoğan yoğun bakım servisimize yatırılan 28 gestasyonel hafta altında pulmoner kanama kriterlerini karşılayan 37 olgu retrospektif olarak değerlendirilmiştir. Doğum ağırlığı ve doğum haftası çalışma grubuna benzer olan ve pulmoner kanaması olmayan 233 prematüre yenidoğan kontrol grubu olarak çalışmaya alınmıştır. Antenatal ve postnatal tıbbi kayıtlar geriye dönük değerlendirilmiştir. Bulgular: Pulmoner kanaması olan prematüreler ile kontrol grubu arasında cinsiyet, sezaryen ile doğum, doğum odasında entübasyon, çoğul gebelik, preeklempsi, erken membran rüptürü, antenatal steroid, patent duktus arteriorus ve erken sepsis sıklığı için farklılık saptanmamıştır. Pulmoner kanaması olan prematürelerde, kontrol grubuna göre pulmoner kanama öncesinde respiratuar distres sendromu (RDS) ve bu nedenle surfaktan verilme sıklığı yüksek saptanmıştır (p<0,05). Sonuç: Artan pulmoner kanama riskinden RDS mi yoksa surfaktan tedavisinin mi sorumlu olduğu ortaya konulamamıştır. Surfaktan ve pulmoner hemoroji arasındaki ilişkiyi ortaya koyan çalışmalara ihtiyaç vardır.

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

Abstract: This data suggests that our current strategy is effective for treating severe pulmonary hemorrhage in VLBW infants. Surfactant therapy for severe pulmonary hemorrhage may also be beneficial for improving lung function and may shorten the duration of high oxygen requirement.

Cited by 38 publications

References 20 publications

Massive pulmonary hemorrhage before living donor liver transplantation in infants

Massive pulmonary hemorrhage before living donor liver transplantation in infants

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

Prematüre yenidoğanlarda pulmoner kanama risk faktörleri

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