RT Book, Section
A1 Gomella, Tricia Lacy
A1 Eyal, Fabien G.
A1 Bany-Mohammed, Fayez
SR Print(0)
ID 1168357042
T1 Pulmonary Hemorrhage
T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781259644818
LK accesspediatrics.mhmedical.com/content.aspx?aid=1168357042
RD 2024/04/20
AB A  nurse  informs  you  that  an  infant  has  bloody  secretions  from  the  endotracheal  tube  (ETT).  Pulmonary  hemorrhageis  bleeding  into  the  lungs.  It  is  typically  an  acute,  catastrophic,  often  life-threatening  event  that  causes  a  sudden  deterioration  in  the  infant’s  clinical  condition  and  is  characterized  by  fresh  continuous  bloody  fluid  from  the  ETT  or  lower  respiratory  tract.  Histologically,  it  is  defined  as  fresh  hemorrhage  in  the  alveolar  spaces  or  interstitium  of  the  lung.  The  incidence  of  pulmonary  hemorrhage  varies  from  1  to  12  per  1000  live  births.  It  can  be  as  high  as  50  per  1000  live  births  if  high  risk  (eg,  premature,  intrauterine  growth  restriction  [IUGR]).  The  mortality  rate  can  be  up  to  50%  in  premature  infants.  Survivors  of  pulmonary  hemorrhage  require  longer  ventilator  support,  and  many  will  develop  bronchopulmonary  dysplasia/chronic  lung  disease  (60%  of  premature  infants).  Studies  show  an  increased  risk  of  death  and  survival  with  neurosensory  impairment,  increased  incidence  of  cerebral  palsy  and  cognitive  delay,  and  an  increased  risk  of  seizures  and  periventricular  leukomalacia  at  18  months  of  age.