Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in newborns

Ferreira, Cristina Helena Faleiros; Carmona, Fábio; Martinez, Francisco Eulógio

doi:10.1016/j.jpedp.2014.05.001

Cited by 15 publications

(26 citation statements)

References 25 publications

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“…Such variations may be expected; however, small study numbers may have confounded our findings. Pulmonary haemorrhage outcomes for preterm infants are poor and mortality rates have been reported as high as 65% (17). Severe IVHs are associated with increased mortality (18), but mortality rates in the context of IVHs causing haemodynamic shock have not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Emergency uncross‐matched blood transfusions in a tertiary neonatal unit

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Emergency uncross‐matched blood transfusions in a tertiary neonatal unit

et al. 2017

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“…[6,11,43,45,47,63]. In the short term, PDA is associated with arterial hypotension, myocardial dysfunction and systemic perfusion [5,8,38], renal functional disturbances [5,19,39], and pulmonary hemorrhage [40,64,65].…”

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Imentioning

confidence: 99%

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

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Introduction: Persistent ductus arteriosus (PDA) is found with increased incidence in preterm infants, significantly affecting neonatal morbidity and mortality rates. Aim: To evaluate the association between the presence of PDA and the severity of clinical condition at birth in critically ill preterm infants, with gestational ages (GA) ≤ 32 weeks and severe respiratory distress. Methods: All preterm infants with GA ≤ 32 weeks admitted to the neonatal intensive care unit (NICU) of the Clinical County Emergency Hospital, Sibiu between 1 January 2010 and 31 December 2015 were included in the study. These were categorized as Group 1 [Preterm infants with PDA; n=154] and Group 2 [Preterm infants without PDA; n=186]. Epidemiological and clinical data were collected in the National Registry for Respiratory Distress Syndrome for all children, and data related to prenatal period, clinical characteristics at birth i.e GA, weight, gender, Apgar scores, and clinical features such as resuscitation at birth, surfactant administration, need and duration of respiratory support, neonatal sepsis, complications associated with prematurity, and death, were analyzed. Results: Group 1 infants had significantly lower GA and birth weights, were more often out born (p=0.049, HR 1.69), and had significantly lower Apgar scores at 1 and 10 minutes (p=0.022, p=0.000). They presented a significantly higher need for surfactant administration (42.9% vs 24.7%, p<0.0001) and respiratory support (96.8% vs 90.3%, HR 3.19, p=0.019 for need of CPAP and 22.1% vs 10.8%, HR 2.35, p=0.004 for mechanical ventilation). Duration of respiratory support was also significantly higher in the Group 1 (7.6%±7.5 vs. 5.1±3.8 days, p<0.0001 for CPAP and 20.1±22.5 vs. 12.0±15.7 days, p<0.0001 for mechanical ventilation). Conclusion:In very preterm infants, PDA may be associated with a critical clinical condition leading to serious complications. The presence of PDA after the seventh day of life was associated with an increased need for respiratory support, both CPAP and mechanical ventilation, increased severity of the respiratory distress syndrome, requiring a longer duration of respiratory support, and increased the hospitalization length. In very preterm infants, PDA presence was also associated with a higher rate of severe complications and death, indicating the need for a careful and proper management of these critical cases in neonatal intensive care units.

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“…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]. In our cohort, the rate of PH in ELBWIs was 18.8%.…”

Section: Discussionmentioning

confidence: 45%

“…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%

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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Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in newborns

Cited by 15 publications

References 25 publications

Emergency uncross‐matched blood transfusions in a tertiary neonatal unit

Emergency uncross‐matched blood transfusions in a tertiary neonatal unit

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

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

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