title: Pulmonary hemorrhage in neonates of early and late gestation.
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 (< or = 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 (> or = 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.
authors.affiliation: Department of Pediatrics, University of Connecticut Health Center, Farmington, USA. bhandarv@aehn2.einstein.edu
authors.forename: V
authors.initials: V
authors.lastname: Bhandari
authors.forename: C
authors.initials: C
authors.lastname: Gagnon
authors.forename: T
authors.initials: T
authors.lastname: Rosenkrantz
authors.forename: N
authors.initials: N
authors.lastname: Hussain
mesh_terms: D001688:Biological Products; D001724:Birth Weight; D003042:Cocaine / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D005865:Gestational Age; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007442:Intubation, Intratracheal; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011175:Positive-Pressure Respiration; D011663:Pulmonary Surfactants / Q000009:adverse effects / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000188:drug therapy; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D011663:Pulmonary Surfactants; D003042:Cocaine; C072197:beractant; D004837:Epinephrine