[Hemorrhagic and hypoxic-ischemic brain lesions in premature infants on artificial ventilation]

Abstract

Major intraventricular hemorrhage (IVH) and cystic leucomalacia (PVL) are major causes of mortality and neurologic morbidity in premature infants that are strongly associated with long-term neurodevelopmental sequelae. Preterm babies ventilated by intermittent positive pressure ventilation are in higher risk for this type of lesion. We studied incidence of major intraventricular bleeding (with ventricular dilatation and parenchymal involvement) and cystic periventricular leucomalacia in 79 preterm babies who required mechanical ventilation for respiratory-distress syndrome (RDS), admitted on Department of Neonatology of the Pediatric University Hospital in Sarajevo from February 1999. to May 2000. Thirty-five babies were classified as less than 32 weeks of gestation. Major intraventricular hemorrhage and cystic leucomalacia were documented in 5 babies (10.2%) of 49 survivors. Two babies developed posthemmoragic hydrocephalus and required shunting. Severe brain damage was more common in ventilated infants with gestational age with (32 weeks of gestation (23.5%) compared with the babies > 32 weeks of gestation (2.9%). The severity of RDS also correlated with an increased risk of severe IVH.