Grossly bloody secretions are seen in the endotracheal tube (ETT). The incidence of pulmonary hemorrhage varies from 0.8 to 12 per 1000 live births. It can be as high as 50 per 1000 live births if high risk. The mortality rate can be as high as 50%. Survivors of pulmonary hemorrhage require longer ventilator support, and many will develop bronchopulmonary dysplasia/chronic lung disease. Others survivors may have an increase in cerebral palsy, cognitive delay, seizures, and periventricular leukomalacia. Most cases of pulmonary hemorrhage are secondary to hemorrhagic pulmonary edema and not a true bleed.