Jump to content

Management Of Massive Pulmonary Haemorrhage


mohamad

Recommended Posts

2 days ago we had a case of full term female suffering from sever perinatal hypoxia and 8 hours after birth she had pulmonary haemorrhage , and she died .

I want to know what is the appropriate management of pulmonary haemorrhage , and what amount of blood components and fluids shoud i give to a neonate loosing large amount of blood in a short time , thank you .

ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ

Mohamad Ismail

Neonatology Resident

Mansoura , Egypt .

Link to comment
Share on other sites

We would use HFOV as our mode of ventilation, and use a distending pressure that is relatively high without leading to over-distension.

We would mostly use erytrocytes, aiming for an EVF around 40. Besides that we would use plasma to support volume and coagulation.

Trombocytes would only be given if trc-penia develops, depending on the dynamics of the trc counts.

Link to comment
Share on other sites

For pulmonary hemorrhage, we go for a high Peep strategy on conventional ventilator. Try to maintain hemodynamic stability. Try to see what is the cause (?DIC , ? PDA). Do NOT overtransfuse packed RBCs when you see Pulmonary Hemorrhage. We have very good experience with activated Factor 7 (Novoseven) in controlling pulmonary hemorrhage.

Link to comment
Share on other sites

  • 2 weeks later...

we use either high peep on conventional ventilator(MAY REACH 8) or HFO .

we try to look for the cause; we do PT and PTT, fbc , if PDA is open or if there is Fulminant sepsis .

we correct thrombocytopenia by plat. transfusion , prolonged coagulation with FFP, and PRBCS FOR ANEMIA .

WE MONITOR CENTRAL BP, SATUARTION AND GAS . ADEQUATE SEDATION OF THE BABY ( MORPHINE OR MIDAZOLAM).

IF WE CAN'T MAINTAIN ADEQUATE OXYGENATION , SURFACTANT CAN BE GIVEN + ADEQUATE VENTILATOR MANGEMENT .

SOMETIMES WE GIVE DIUREITCS (LASIX) .

AVOID TOO MUCH SUCTIONING , FLUID MANAGEMENT ACCORDING TO SUSPECTED CAUSE , CORRECTION OF ACID BASE DISTURBANCES .

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...