Pulmonary hemorrhage in neonatal respiratory distress syndrome: Radiographic evolution, course, complications and long-term clinical outcomes

Autor:	A Yu, Pallavi Sagar, Katherine Nimkin, Randheer Shailam, K Wu, M Lee, Sergei Roumiantsev
Rok vydání:	2019
Předmět:	Lung Diseases Male Neonatal respiratory distress syndrome Administration Topical Radiography Birth weight Hemorrhage Comorbidity 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans Child Lung Bronchopulmonary Dysplasia Cerebral Intraventricular Hemorrhage Retrospective Studies Respiratory Distress Syndrome Newborn 030219 obstetrics & reproductive medicine Respiratory distress business.industry Infant Newborn Infant Gestational age Pulmonary Surfactants medicine.disease Postnatal age Intraventricular hemorrhage Child Preschool Anesthesia Pediatrics Perinatology and Child Health Disease Progression Female Radiography Thoracic Pulmonary hemorrhage business Infant Premature Follow-Up Studies
Zdroj:	Journal of Neonatal-Perinatal Medicine. 12:161-171
ISSN:	1878-4429 1934-5798
DOI:	10.3233/npm-1867
Popis:	Background Pulmonary hemorrhage (PH) is occasionally seen in premature infants after surfactant treatment for respiratory distress syndrome (RDS). These infants receive frequent chest radiographs (CXR) during and after hospitalization enabling long-term radiographic-clinical correlation. Objective To chart the natural evolution of CXR findings of PH in RDS and correlate radiographic patterns to supplemental oxygen requirement. Materials and methods Retrospective review of clinical notes for gestational age (GA), birth weight (BW), intraventricular hemorrhage (IVH) and oxygen requirement were performed. CXRs were reviewed at 4 time-points; during PH, 28 days postnatal age, 36 weeks and at farthest available clinical follow-up. Results 18 infants born (2003-2016), GA (24-30 weeks); BW (482-1590 grams) were included. Mean onset of PH was 1.94 (0-5) days. 9/18 (50%) had IVH. 3 died during PH; all had IVH. During PH, CXR showed whiteout 9/18 (50%); patchy opacities 5/18 (27%); diffuse haziness 1/18 (6%) and no change 3/18 (17%). At 28 days postnatal age, CXR showed fine-interstitial (FI) markings 14/15 (93%) and whiteout 1/15 (7%). At 36 weeks,12/14 (85%) had FI and 2/14 (15%) developed cystic-interstitial changes. At farthest follow-up, FI 3/13 (23%); coarse-interstitial 4/13 (30%); peri-bronchial cuffing 5/13 (38%); normal 1/13 (9%) and the majority had hyperinflation 9/13 (69%). At discharge, 9/14 (64%) required home-oxygen and 5/14 (36%) were on room-air. At farthest follow-up, 6/14 (42%) required home-oxygen and 8/14 (58%) were on room-air. Conclusion Premature infants that survive PH may later develop chronic lung disease of prematurity with an evolving interstitial pattern on CXR that clears overtime as they outgrow the need for supplemental oxygen.
Databáze:	OpenAIRE
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