CLINICAL EVENTS IN ASSOCIATION WITH TIMING OF INTRAVENTRICULAR HEMORRHAGE IN PRETERM INFANTS
CLINICAL EVENTS IN ASSOCIATION WITH TIMING OF INTRAVENTRICULAR HEMORRHAGE IN PRETERM INFANTS
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DOI：
10.1016/s0022-3476(05)81157-6
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发表时间：
1992-10-01
影响因子：
5.1
通讯作者：
SHIMADA, S
中科院分区：
文献类型：
--
作者：
FUNATO, M;TAMAI, H;SHIMADA, S
为了确定新生儿重症核心病房中的任何常规做法或临床操作是否会诱发早产儿脑室内出血（IVH），我们对 33 名患有呼吸窘迫的极早产儿进行了 48 小时的生发层连续超声监测。其中 16 名婴儿出现脑室内出血。通过超声波监测确认了四名婴儿生发层出血的时间。四个病例中的三个明显与 IVH 时发生的临床事件相关：手动通气以改善与新生儿原发性肺动脉高压相关的高碳酸血症；通过给予葡萄糖酸钙和碳酸氢钠纠正导致心律失常的高钾血症；给予表面活性剂-TA改善肺出血引起的呼吸衰竭。在这三个婴儿中，诱发IVH的基本因素之一可能是伴或不伴高碳酸血症的血压升高，导致生发层缺血损伤后的脑再灌注。
To ascertain whether any routine practices or clinical manipulations in a neonatal intensive core unit could induce intraventricular hemorrhage (IVH) in preterm infants, we performed ultrasonic monitoring of the germinal layer continuously for 48 hours in 33 extremely premature infants with respiratory distress. Intraventricular hemorrhage developed in 16 of these infants. In four infants the timing of the germinal layer hemorrhage was confirmed with ultrasonic monitoring. Three of the four cases were apparently associated with clinical events occurring at the moment of IVH: manual ventilation for improvement of hypercapnia associated with primary pulmonary hypertension of the newborn; correction of hyperkalemia, which was causing an arrhythmia, with administration of calcium gluconate and sodium bicarbonate; and administration of surfactant-TA to improve respiratory failure caused by pulmonary hemorrhage. In these three infants it appeared that one of the basic factors inducing IVH might be an increase in blood pressure with or without hypercapnia, causing cerebral reperfusion after ischemic damage of the germinal layer.