Pulmonary hemorrhage in neonates of early and late gestation
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Vineet Bhandari
Abstract
Our objectives in this study of pulmonary hemorrhage (PH) were to define common characteristics of infants who develop PH, identify factors associated with PH and report the outcome. Neonates (42/2980 admissions) with PH and matched controls were identified. Early gestation ≤35 weeks) infants with PH [EGPH] (n = 34; 12 survived) had occurrence of PH at 3.6 ± 1.1 (mean ± sem) days and were significantly associated with multiple births (p = 0.03), RDS (p < 0.01) and use of Survanta (p < 0.02). Among EGPH, small for gestational age (SGA) infants (n = 7) had a 100% mortality rate. Late gestation (≥ 36 weeks) infants with PH [LGPH] (n = 8; 6 survived) had occurrence of PH at 0.7 ± 0.3 days and were significantly associated with low 1 minute (p = 0.04) and 5 minutes (p = 0.01) Apgar scores. All infants were managed with increases in mean airway pressure (MAP) and/or use of cocaine/epinephrine through the endotracheal tube. We have identified 2 groups of neonates with distinct factors associated with PH; use of 1:10,000 epinephrine (0.1 ml/kg) and/or 4% cocaine (4 mg/kg) may be useful adjuncts to increases in MAP for management of PH.
Copyright (c)1999 by Walter de Gruyter GmbH & Co. KG
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Artikel in diesem Heft
- Cord occlusion techniques for selective termination in monochorionic twins
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- MMP/TIMP imbalance in amniotic fluid during PROM: an indirect support for endogenous pathway to membrane rupture
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