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Rt 104


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What is PIE
Pulmonary Interstitial Emphysema
What is the Definition of IVH
Intraventicular hemorrhage (IVH) is bleeding inside, or around the ventricles, the spaces in the brain containing the cerebral spinal fluid.
Intraventicular hemorrhage (IVH) - Most common in premature babies?
1. Specially in very low birth weight less than 1.5 Kg
2. Infants 24 – 32 weeks gestation are at greater risk
Pathophysiology of Intraventicular hemorrhage (IVH)
1. Bleeding can rupture because blood vessels in a premature baby’s brain are very fragile and immature and can easily rupture.
2. Babies with RDS or other complications of prematurity are more likely to have IVH.
3. The smaller and more premature the baby, the more likely IVH will occur.
4. Nearly all IVH occurs within the 1st 3 days of life
What are the (4) grades of IVH
Grade 1 – bleeding occurs just in a small area of ventricles
Grade 2 – bleeding also occurs inside the ventricles
Grade 3 – ventricles are enlarged by the blood
Grade 4 – bleeding also occurs in the brain tissues around the ventricles (irreversible)
What are the (2) most common Grades in IVH
Grades 1 and 2
Occurs in about 75% of babies with IVH
What are the (2)most serious Grades in IVH
Grades 3 and 4 are the most serious
What complications can occur with severe Grades in IVH
May lead to hydrocephalus in severe cases
Usually results in long-term brain injury to baby
How is IVH Diagnosed
1. A cranial ultrasound is used
2. Cranial ultrasound ca be view the inside of the baby’s brain through the fontanelles.
3. With ultrasound, the amount of bleeding can be graded
How is IVH Treated
1. There is no specific treatment for IVH
Prevention is best treatment
In the treatment of IVH, What can be given to the mother
1. corticosteroids before delivery has been shown to lower the risk of IVH in baby
When giving steroids, what are the (4) avoidant wide swings
1. B/P
2. Oxygenation
3. pH
4. Low dose Indomethacin
However may cause ductus arteriousus

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