Term
| Where does intraventrical haemorrhages originate from? |
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Definition
| Subependymal germinal matrix |
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Term
| Why is the germinal matrix prone to haemorrhage? |
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Definition
Highly vascular
Immature: lacks structural support, gaps between endothelium |
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Term
| Intraventricular haemorrhage is more common in term neonates? True or false |
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Definition
| False, it is more common in preterm neonates because the germinal matrix is still developping. |
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Term
| Why does sodium bicarbonate needs to be administered slowly and diluted? |
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Definition
| To avoid cerebral blood flow disturbances |
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Term
The majority of intraventricular haemorrhages happen during the first 24 hours of life?
True or false |
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Definition
True
Between 24 hrs and 5 days |
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Term
| A 23 weeker baby will remain at increase risk of intraventricular haemorrhage for the first month of life? True or false |
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Definition
| False The risk period is independent of the gestational age. |
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Term
| Up to 50% of neonates show no signs when the intraventricular haemorrhage happens? True or false |
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Definition
| 25-50 % of intraventricular haemorrhages are silent. |
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Term
| What is the best diagnostic method to detect an intraventricular haemorrhage? |
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Definition
Head ultrasound
MRI can also be used, but the baby needs to be stable enough to leave the neonatal unit. |
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Term
| Adam, a 28 weeker, was born 12 hours ago and is hypotonic, has worsening respiratory distress and has funny eye movements? What do you suspect? |
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Definition
| Intraventricular haemorrhage These are non specific manifestations which are the most common and they develop over hours to days. Other manifestations include altered level of consciousness and decrease spontaneous movements. |
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Term
| When should head ultrasounds be performed? |
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Definition
| According to the Practice Committee of the Child Neurology Society - Routine < than 30 weeks GA - Perform 7-14 days of age - Repeated 36-40 weeks Consider infants abnormal clinical signs, critically ill, or other major risk factors |
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Term
| What is the best way to prevent intraventricular haemorrhage? |
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Definition
| Antenatal corticosteroids Stabilisation microvasculature germinal matrix (↓ haemorrhage) and ↓ RDS (improve CBF) |
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Term
| As a nurse, what can you do to prevent intraventriular haemorrhage? |
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Definition
| - Respiratory system: No routine suctioning, optimize ventilation/oxygenation, prevent pneumotharax, apneas, synchronize ventilation - Timely blood gases - Slow and diluted bicarbonate infusion - Appropriate resuscitation - Normotension - Normothermia - Developmental care (Decrease pain, crying and stress, minimise handling, head midline and elevated) |
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Term
| Name 2 complications of grade III and IV haemorrhages. |
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Definition
Post haemorrhagic hydrocephalus (50%)
Cerebral palsy (30%)
Developmental delay (17.5%)
Seizures (5 - 10%)
Deafness (8.6%)
Blindness (2.2%)
↑ mortality |
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Term
| Neurodevelopment follow-up and early intervention are known to increase quality of life. True or false |
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Definition
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