title: Risk factor profile of massive pulmonary haemorrhage in neonates: the impact on survival studied in a tertiary care centre.
abstract: OBJECTIVE
  Pulmonary haemorrhage (PH) in neonates is a fatal event leading to hazardous complications and even death. The aim of this study was to elucidate influential factors of the ultimate disease course that affect death or survival.
  
  
  METHODS
  Infants treated for PH in our institution from March 2009 to December 2013 were retrospectively reviewed. Infants transferred from other hospitals were excluded. Infants were grouped into two categories, deceased or survived at neonatal intensive care unit discharge. Information regarding perinatal history, initial management and laboratory results were obtained and analysed for each group.
  
  
  RESULTS
  Seventy infants fulfilled the inclusion criteria, 41 infants in the deceased group and 29 infants in the survived group. Overall, the infants in the deceased group displayed lower gestational age (27 and 1/7 ± 3.610 versus 29 and 3/7 ± 3.530 weeks, p = 0.009) and lower one-minute (2.342 ± 1.493 versus 4.035 ± 2.079, p < 0.001) and five-minute Apgar scores (2.342 ± 1.493 versus 4.035 ± 2.079, p < 0.001) and required aggressive resuscitation (p = 0.003) and a greater number of inotropes (2.195 ± 1.346 versus 1.069 ± 0.704, p < 0.001). Deceased infants were administered increased amounts of fluid during the first 24 h after birth (117.783 ± 32.325 versus 99.379 ± 17.728 mL/kg, p = 0.004). A relatively short prothrombin time impacted survival (p = 0.01), whereas platelet count was the only factor that significantly affected the time length from the onset of PH to death (p = 0.01).
  
  
  CONCLUSIONS
  Infants with a lower gestational age in a compromised state are prone to die once PH develops. The initial management of fluid intake not to exceed the adequate limit is especially important in order to prevent PH-related deaths when correcting hypoalbuminemia and coagulopathy.
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: Sook Kyung
authors.initials: SK
authors.lastname: Yum
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: Cheong-Jun
authors.initials: CJ
authors.lastname: Moon
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: Young-Ah
authors.initials: YA
authors.lastname: Youn
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Lee
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: a Division of Neonatology, Department of Pediatrics , College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
authors.forename: In Kyung
authors.initials: IK
authors.lastname: Sung
mesh_terms: D005260:Female; D006470:Hemorrhage / Q000401:mortality*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008171:Lung Diseases / Q000401:mortality*; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Death; neonatal intensive care unit; pulmonary haemorrhage; risk factor; survival