[Massive pulmonary hemorrhage in surgical pathology of the newborn infant]. / La hemorragia pulmonar masiva en la patología quirúrgica del recién nacido.

Massive pulmonary hemorrhage is a complication which frequently leads to death in newborns with conditions susceptible to surgical treatment. Out of 112 postmortem studies, focal hemorrhage was found in 38 (33.9%) and massive in 34 cases (30.3%). In this series, congenital anomalies were found in digestive tract in 70.5% of the patients. Prematurity andlow weight were not important factors as was hypoxia, which was evident in 70.5% of the cases. Manifestations of respiratory insufficiency, shock, rales in lung fields, bleeding in other places different from the lung, blood leaking through upper respiratory ducts, are all clinical features of diagnostic aid. Disturbances in coagulation tests were detected, the same as drop in figures of hemoglobin, acidosis, hypoxia and hypercapnia. Gram-negative germs, with a predominance of Klebsiella, were isolated in 33 cultures. The radiographic finding with reticulogranular image was unfrequent. Among other precipitating factors of pulmonary hemorrhage, identification was made of the surgical disease by itself, surgical and anesthetic procedures, of ventilatory assistance and therapy with oxygen at high concentration for long periods of time.