RT Book, Section A1 John, Elaine Barefield St. A1 Carlo, Waldemar A. A2 Stevenson, David K. A2 Cohen, Ronald S. A2 Sunshine, Philip SR Print(0) ID 1109793247 T1 Pulmonary Hemorrhage T2 Neonatology: Clinical Practice and Procedures YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071763769 LK accesspediatrics.mhmedical.com/content.aspx?aid=1109793247 RD 2024/03/29 AB Pulmonary hemorrhage (PH) is the appearance of bright red blood from the trachea in association with acute pulmonary compromise and radiographic changes. Prior to the advent of exogenous surfactant, PH was described as a disorder primarily in term infants, in addition to the occasional very ill preterm infant, with sepsis, asphyxia, hypothermia, Rh disease, intrauterine growth retardation (IUGR), heart failure, or coagulopathy. The incidence was estimated at 1.3/1000 births1 and 18/1000 in very low birth weight (VLBW) infants.2 In recent decades, PH is more often a complication of extreme prematurity and is becoming more common as smaller, more immature infants are provided intensive care. PH is most often seen in extremely immature infants after surfactant administration,3,4 particularly when the ductus arteriosus is still patent.5, 6, and 7 The incidence of PH in VLBW infants in the immediate postsurfactant era was estimated between 3% (according to Braun et al2) and 5.7% (according to Tomaszewska et al3) and has progressively increased since 1998 (Figure 25-1).8 Although once viewed as almost uniformly fatal, the mortality now is closer to 50% in VLBW infants.3 PH accounted for 18% of all deaths in a large series of infants at 23 weeks’ gestation.9