Causes and management of pulmonary haemorrhage in the neonate

Bendapudi, Perraju; Narasimhan, R; Papworth, S.

doi:10.1016/j.paed.2012.08.008

Cited by 11 publications

(14 citation statements)

References 12 publications

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“…A systemic deterioration is established with metabolic acidosis and shock. Investigations should include a chest X-ray, an echocardiogram (to exclude a PDA), work-up for sepsis, and eventual screening for hereditary diseases of coagulation (if no other risk factors are detected) [ 119 ].…”

Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

“…Treatment should include general supportive measures: transfusions of blood, plasma or platelets, as indicated; correction of metabolic acidosis; inotropic drugs to improve systemic blood pressure; PDA treatment (except severe thrombocytopenia); antibiotic treatment including vancomycin; and coverage for Gram-negative bacteria [ 118 , 119 ].…”

Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

“…In conventional ventilatory support, the increase in settings is recommended (higher frequency (F), higher positive end expiratory pressure (PEEP), and higher mean airway pressure (Pāw)). Although without evidence, observational studies suggest that the support with high-frequency oscillatory ventilation (HFOV) allows to control more cases of pulmonary hemorrhage when comparing to conventional support [ 118 , 119 ].…”

Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

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Respiratory Care for the Ventilated Neonate

Rocha¹,

Soares

Gonçalves³

et al. 2018

Canadian Respiratory Journal

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Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual capacity. Pathologies affecting the newborn's lung are also different from many others observed later in life. Several different ventilation modes and strategies are available to optimize mechanical ventilation and to prevent ventilator-induced lung injury. Important aspects to be considered in ventilating neonates include the use of correct sized endotracheal tube to minimize airway resistance and work of breathing, positioning of the patient, the nursing care, respiratory kinesiotherapy, sedation and analgesia, and infection prevention, namely, the ventilator-associated pneumonia and nosocomial infection, as well as prevention and treatment of complications such as air leaks and pulmonary hemorrhage. Aspects of ventilation in patients under ECMO (extracorporeal membrane oxygenation) and in palliative care are of increasing interest nowadays. Online pulmonary mechanics and function testing as well as capnography are becoming more commonly used. Echocardiography is now a routine in most neonatal units. Near infrared spectroscopy (NIRS) is an attractive tool potentially helping in preventing intraventricular hemorrhage and periventricular leukomalacia. Lung ultrasound is an emerging tool of diagnosis and can be of added value in helping monitoring the ventilated neonate. The aim of this scientific literature review is to address relevant aspects concerning the respiratory care and monitoring of the invasively ventilated newborn in order to help physicians to optimize the efficacy of care.

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Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

Section: Complications: Air Leaks and Pulmonary Hemorrhagementioning

confidence: 99%

See 1 more Smart Citation

Respiratory Care for the Ventilated Neonate

Rocha¹,

Soares

Gonçalves³

et al. 2018

Canadian Respiratory Journal

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“…Its pathogenesis is thought to be due to pulmonary edema with a hemorrhagic component, as analysis of the hemorrhagic fluid has shown a lower hematocrit than the infants' blood. 1 Infants with PH commonly present with an acute decline in clinical status, often with hypotension, bradycardia, pallor, and hypoxia. Signs and symptoms of heart failure may also be noted including tachycardia, hepatosplenomegaly, peripheral edema, and a heart murmur.…”

Section: Introductionmentioning

confidence: 99%

“…The condition is managed supportively, with airway clearance, epinephrine administration via endotracheal tube, fluid resuscitation, and invasive ventilation techniques. 1 PH has an incidence of approximately 0.1% in all newborns, but this increases to 5% to 11% in infants who are preterm or experience intrauterine growth restriction. Other major risk factors for PH include use of surfactant therapy in infants with respiratory distress syndrome (RDS), patent ductus arteriosus, and coagulopathy.…”

Section: Introductionmentioning

confidence: 99%

Perinatal Pulmonary Hemorrhage: A Retrospective Autopsy Case Series

Agarwal

Ernst

2020

Pediatr Dev Pathol

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Perinatal pulmonary hemorrhage (PH) is a condition characterized by blood loss via the respiratory tract with an approximate incidence of 0.1% in all newborns. The histologic characteristics of the lung in PH are not well characterized, and we hypothesized that pulmonary maldevelopment such as pulmonary hypoplasia may contribute to PH. In addition, we sought to find any correlations with placental pathology. Retrospective study of fetal and neonatal autopsies with diagnosis of PH was performed between the years from 2009 to 2015. Autopsy reports, placental pathology reports, and hematoxylin and eosin sections of the lung were reviewed. Of the 17 cases which were identified meeting inclusion criteria, PH ranged from mild (<5% in each lung) to severe (>75% in both lungs). PH involved >50% of both lungs in 6 cases. Pulmonary hypoplasia was designated in 7 of 17 (41.17%) cases with PH. Pulmonary hypoplasia and/or persistence of intra-acinar arterioles was seen in 13 of 17 (76.4%) cases. No specific placental pathology was seen universally in the cases of PH, but either maternal or fetal vascular malperfusion was noted in 14 of 17 (82%) cases. Our data suggest a high prevalence of pulmonary maldevelopment, such as pulmonary hypoplasia and persistence of intra-acinar arterioles, in cases with PH. Although no specific placental pathology is seen in PH, maternal and fetal vascular pathology is common.

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Respiratory Disorders in the Preterm Infant

Jackson¹

2018

Avery's Diseases of the Newborn

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Causes and management of pulmonary haemorrhage in the neonate

Cited by 11 publications

References 12 publications

Respiratory Care for the Ventilated Neonate

Respiratory Care for the Ventilated Neonate

Perinatal Pulmonary Hemorrhage: A Retrospective Autopsy Case Series

Respiratory Disorders in the Preterm Infant

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