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Risk factors in the development of intra ventricular hemorrhage in the preterm neo nate


Archives of Disease in Childhood 57(6): 410-417
Risk factors in the development of intra ventricular hemorrhage in the preterm neo nate
Infants (146) of .ltoreq. 34 wk gestation were repeatedly scanned by real-time ultrasound to diagnose the presence of intraventricular hemorrhage (IVH), its severity, and the timing of onset of the condition. A new method is described for grading the extent of IVH which does not depend on ventricular size. IVH was clearly present in 52 (36%) of the 146 infants and in 32 (50%) of the 64 infants of .ltoreq. 30 wk gestation. Repeated scans accurately timed the onset of IVH in 41 infants, and 32 (78%) had the 1st sign of IVH before 72 h of age. Clinical factors (32) were analyzed for possible correlation with the development of IVH: outborn compared with inborn, administration of sodium bicarbonate, hypothermia, intermittent positive pressure ventilation, continuous positive airways pressure, hypercapnia, severe acidosis and respiratory distress syndrome all reached statistical significance. Analysis of variance showed that respiratory distress syndrome was the most important factor, but severe acidosis had some independent action on the development of IVH. Of 21 infants with hypercapnia (PCO2 [partial pressure of CO2] > 6 kPa [kilopascal]) together with severe acidosis (pH < 7.1), 17 (81%) developed IVH, of which more than half was moderate or severe in degree.


Accession: 006345398



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