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1075 Risk Factors for Posthemorrhagic Hydrocephalus in a Neonatal Intensive Care Unit

Background and aim Post-hemorrhagic hydrocephalus (PHH) is one of the most serious complications of intraventricular hemorrhage (IVH) in a newborn. Causes are multifactorial including genetical, pre and postnatal complications. Conditions assosciated with hydrocephalus following IVH were investigate...

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Published in:Archives of disease in childhood 2012-10, Vol.97 (Suppl 2), p.A308-A309
Main Authors: Kulalı, F, Altuntas, N, Kazancı, E, Aktas, S, Unal, S, Hirfanoglu, I, Onal, E, Turkyılmaz, C, Koc, E, Atalay, Y, Ergenekon, E, Gucuyener, K
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Language:English
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Summary:Background and aim Post-hemorrhagic hydrocephalus (PHH) is one of the most serious complications of intraventricular hemorrhage (IVH) in a newborn. Causes are multifactorial including genetical, pre and postnatal complications. Conditions assosciated with hydrocephalus following IVH were investigated. Methods Charts of patients admitted to the neonatal intensive care unit (NICU) over last 5 years were investigated retrospectively, newborns with grade 3–4 IVH were analyzed for risk factors in the perinatal and neonatal period. Ones with and without hydrocephalus were compared. Results are expressed as median and range and percentage where required. Results 24 newborns were diagnosed with IVH, 9 of whom developed hydrocephalus. Most significant risk factors are shown in table 1. Abstract 1075 Table 1 Female(%) Male (%) PPV in DR (%) Asidosis (%) Hypercarbia (%) Hypotension (%) Pneumothorax (%) Low Plt (%) PHH (+)n=9 44 56 44 78 78 78 11 66 PHH (-)n=16 31 69 32 37 44 44 25 62 Hypotension, asidosis, were more frequent in the PHH group. GA, BW, Apgar scores, lowest-highest CO2, Crib score are shown in table 2. Abstract 1075 Table 2 GA (w) BW (g) Crib Score 1st min Apgar 5th min Apgar Lowest CO2 (mmHg) Highest CO2 (mmHg) PHH (+)n=9 31 (26–38) 1715 (866–3330) 3 (0–14) 7 (1–9) 9 (6–10) 29 (18–59) 117 (84–187) PHH (-)n=16 34 (24–40) 1820 (660–4000) 2.5 (0–11) 7 (1–9) 9 (3–10) 28 (16–43) 65 (31–180) p 0.2 0.44 0.5 0.6 0.8 0.8 0.044 Highest CO2 in the first 10 days of life was significantly higher in the PHH group (p=0.044). Conclusion PHH remains to be one of the most severe complications of IVH. In this small group of patients, high CO2 levels, hypotension seem to be important risk factors.
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2012-302724.1075