[Intraventricular hemorrhages in hyaline membrane disease]

Twenty prematures children with hyaline membrane disease treated by artificial ventilation under continuous alveolar distension pressure, died after intra-ventricular hemorrhage (group I). These cases have been compared to 20 surviving children, with respiratory diseases of similar severity, and supposed to be uninjured with regard to such cerebral lesions (group II). During the first two days of life, the frequency of important hypothermia, hemodynamic instability with tendency to collapse, metabolic or mixed recurring acidosis were significantly more frequent in group I than in group II. These abnormalities probably promote bleeding; their practical consequences are discussed. On the other hand, perinatal suffering and distrubances in blood coagulation do not take a determinant part. The further aggravation of the neurological status, after an lay phase, unexplained and important hematocrit drop, presence of blood at lumber puncture and, overall, at the electro-encephalogram rolandic sharp spikeswaves constitute the major arguments for the diagnosis of hemorrhage.