Pulmonary hemorrhage in preterm neonates: risk factors and management

Pulmonary hemorrhage in neonates is an acute catastrophic event requiring prompt recognition and emergency intervention. It represent one end of a spectrum of disorders characterized by pulmonary oedema. It is characterized by sudden onset, rapid progression into respiratory failure and high mortality. Twenty two babies with documented pulmonary hemorrhage were analysed for risk factors. High frequency oscillatory ventilation [HFOV] as a rescue strategy for respiratory support of those patients was assessed by comparing oxygenation before and after its use. Pulmonary hemorrhage was exclusively seen among preterm babies during the period of the study. Al 22 babies suffered a primary respiratory illness namely respiratory distress syndrome [RDS], all [100%], received surfactant. Fourteen babies [70%] had patent ductus arteriosus [PDA]. Out of 22 babies, 7 babies [2%] expired, 15 babies [68%] survived. Oxygenation improved after HFOV. In survivors, oxygen index [OI] before HFOV was 14.2 +/- 1.1, compared to 14.9 +/- 1.2 in non survivors. While, after HFOV, OI was 6.7 +/- 0.7 in survivors, compared to 12.8 +/- 1.2 in non survivors. P-value<0.05. A similar trend was seen for a/ApO[2]. Pulmonary hemorrhage is a life threatening condition, with high mortality rate. Mortality is more common in extremely low birth weight infants [ELBW], who had RDS, received surfactant therapy and had significant PDA.HFOV is a good option to ventilate those babies who suffered this serious complication

Neonatal cardiac failure - a pulsating brain

Arterio-venous malformations should be considered in the case of neonatal cardiac failure with normal echocardiogram. A rare case of Vein of Galen Aneurysmal Malformation [VGAM] resulting in neonatal high output cardiac failure is reported. Clinical presentation, imaging techniques, and prognosis of this disorder is discussed. The advance in management including endovascular emobilization at special centers and the outcome is outlined

Effcacy of carvedilol in the treatment of doxorubicin- induced cardiomyopathy in a pediatric patient

We report a pediatric case with doxorubicin-induced cardiomyopathy that failed to respond to conventional heart failure medication but improved significantly when placed on carvedilol over a period of one year

Delleman syndrome: a known case with an unusual finding

A new case of Delleman syndrome [oculocerebro-cutaneous syndrome] with predominant and typical cutaneous involvement is association with coarctation of the aorta is reported