Risk factors of pulmonary hemorrhage in preterm infants

Yıl 2015, Cilt: 46 Sayı: 3, 116 - 119, 24.06.2015

Elif Özalkaya , Hande Özgün Karatepe Sevilay Topçuoğlu Emre Dinçer Güner Karatekin Fahri Ovalı

https://doi.org/10.16948/zktb.38501

Cited By: 1

Öz

Objective: To determine the frequency and the risk factors of pulmonary hemorrhage ın preterm infants

Material and Method: In this study 37 preterm infants hospitalized between January 2012 to January 2015 with the diagnosis of pulmonary hemorrhage and less than 28 gestational weeks were evaluated retrospectively. 233 preterm infants whose birth weight and gestational week are similar to study group and without pulmonary hemorrhage are taken as control group. Antenatal and postnatal medical records evaluated retrospectively.

Results: No difference have been showed between study groups for gender, cesarean delivery, multiple pregnancies, intubation in delivery room, preeclampsia, premature rupture of membranes, maternal use of corticosteroids, patent ductus arteriosus and early onset sepsis. Newborns who had pulmonary hemorrhage had respiratory distress syndrome and received surfactants more frequently than the control group.

Conclusion: In this study whether the increasing risk factor of pulmonary hemorrhage is because of RDS or treatment of surfactant has not been revealed. There needs more study to reveal the relationship between pulmonary hemorrhage and surfactant treatment.

Anahtar Kelimeler

premature, hemorrhage, surfactant

Prematüre yenidoğanlarda pulmoner kanama risk faktörleri

Öz

Amaç: Prematürelerde pulmoner kanama sıklığı ve risk faktörlerini saptamaktır.

Gereç ve Yöntem: Bu çalışmada Ocak 2012 ile Ocak 2015 arasında yenidoğan yoğun bakım servisimize yatırılan 28 gestasyonel hafta altında pulmoner kanama kriterlerini karşılayan 37 olgu retrospektif olarak değerlendirilmiştir. Doğum ağırlığı ve doğum haftası çalışma grubuna benzer olan ve pulmoner kanaması olmayan 233 prematüre yenidoğan kontrol grubu olarak çalışmaya alınmıştır. Antenatal ve postnatal tıbbi kayıtlar geriye dönük değerlendirilmiştir.

Bulgular: Pulmoner kanaması olan prematüreler ile kontrol grubu arasında cinsiyet, sezaryen ile doğum, doğum odasında entübasyon, çoğul gebelik, preeklempsi, erken membran rüptürü, antenatal steroid, patent duktus arteriorus ve erken sepsis sıklığı için farklılık saptanmamıştır. Pulmoner kanaması olan prematürelerde, kontrol grubuna göre pulmoner kanama öncesinde respiratuar distres sendromu (RDS) ve bu nedenle surfaktan verilme sıklığı yüksek saptanmıştır (p<0,05).

Sonuç: Artan pulmoner kanama riskinden RDS mi yoksa surfaktan tedavisinin mi sorumlu olduğu ortaya konulamamıştır. Surfaktan ve pulmoner hemoroji arasındaki ilişkiyi ortaya koyan çalışmalara ihtiyaç vardır. 

Anahtar Kelimeler

prematüre, pulmoner kanama, surfaktan

Kaynakça

• Pandit PB, O’Brien K, Asztalos E, Colucci E, Dunn MS. Out-come following pulmonary haemorrhage in very low birth weight neonates treated with surfactant. Arch Dis Child Fetal Neonatal Ed. 1999;81(1): 40-4.
• Raju TN, Langenberg P. Pulmonary hemorrhage and exoge-nous surfactant therapy: a metaanalysis. J Pediatr. 1993;123(4):603-10.
• Braun KR, Davidson KM, Henry M, Nielsen HC. Severe pulmonary hemorrhage in the premature newborn infant:analysis of presurfactant and surfactant eras. Biol Neonate.1999;75 (1) :18-30
• Tomaszewska M, Stork E, Minich NM, Friedman H, Berlin S,Hack M. Pulmonary hemorrhage: clinical course and outcomes among very low-birth-weight infants. Arch Pediatr Adolesc Med.1999;153 (7):715-21.
• Zahr RA, Ashfag A, Marron-Corwin M. Neonatal pulmonary hemorrhage. NeoReviews. 2012;13 (5): 302-06.
• Papworth S, Cartlidge P.H.T. Pulmonary haemorrhage. Paediatrics. And Child Health. 2001;1 (3): 167-71.
• Kluckow M, Evans N. Ductal shunting, high pulmonary blood flow, and pulmonary hemorrhage. J Pediatr 2000;137(1): 68-72.
• Finlay ER, Subhedar NV. Pulmonary haemorrhage in preterm infants. Eur J Pediatr 2000;159(11):870-71.
• Yen TA, Wang CC, Hsieh WS, Chou HC, Chen CY, Tsao PN. Short-term outcome of pulmonary hemorrhage in very-low-birth-weight preterm infants. Pediatrics and Neonatology. 2013;54(5):330-34.
• Findlay RD, Taeusch HW, David- Cu R, Walther FJ. Lysis of red blood cells and alveolar epithelial toxicity by therapeutic pulmonary surfactants. Pediatr Res 1995;37(1): 26-30.
• Dufourq N, Thomson M, Adhikari M, Moodley J. Massive pulmonary haemorrhage as a cause of death in the neonate a retrospective review. S Afr Med J 2004;94(4): 299-302.
• Lin TW, Su BH, Lin HC, Hu PS, Peng CT, Tsai CH, et al. Risk factors of pulmonary hemorrhage in very-low-birth-weight infants: a two-year retrospective study. Acta Paediatr Taiwan 2000;41(5): 255-58.
• Pandit PB, Dunn MS, Colucci EA. Surfactant therapy in neonates with respiratory deterioration due to pulmonary hemorrhage. Pediatrics 1995;95(1): 32-36.
• Pandit PB, Dunn MS, Kelly EN, Perlman M. Surfactant replacement in neonates with early chronic lung disease. Pediatrics 1995;95(6): 851-54.
• Berger TM, Allred EN, Van Marter LJ. Antecedents of clinically significant pulmonary hemorrhage among newborn infants. J. Perinatol.2000;20(5): 295-300.
• Ferreira CH, Carmona F, Martinez FE. Prevelance, risk factors and outcomes associated with pulmonary hemorrhafe in newborns. Jornal de Pediatria 2014;90(3): 316-22.
• Scholl JE, Yanowitz TD. Pulmonary Hemorrhage in Very Low Birth Weight Infants:A Case- Control Analysis. J Pediatr. 2015; 166(4): 1083-4.
• Bhandari V, Gagnon C, Rosenkrantz T, Hussain N. Pulmonary hemorrhage in neonates of early and late gestation. J. Perinat Med. 1999; 27(5):369-75.
• Raju TN, Langenberg P. Pulmonary hemorrhage and exogenous surfactant therapy: a metanalysis. J.Peditr 1993; 123 (4):603-10.
• Findlay RD, Taeusch HW, David- Cu R, Walther FJ. Lysis of red blood cells and alveolar epithelial toxicity by therapeutic pulmonary surfactants. Pediatr Res 1995;37(1): 26-30.
• Aziz A, Ohisson A. Surfactant for pulmonary hemorrhage in neonates. Cochrane Database Syst Rev 2012;11;7:CD005254.
• Strauss T, Rozenzweig N, Rosenberg N, Shenkman B, Livnat T, Morag I, Fruchtman Y, Martinowitz U, Kenet G. Surfactant impairs coagulation in-vitro: a risk factor for pulmonary hemorrhage? Thromb Res. 2013;132(5):599-603.