Intensive care of intracranial hemorrhages in infants: а 5-year single-center experience

Introduction: Prevention of hemorrhagic disease in newborns (HDN) in recent years has significantly reduced the number of intracranial hemorrhages (ICH) associated with these pathologies and the most common etiological cause of hemorrhagic stroke in infants. However, the issues of intensive therapy for intracranial hemorrhages in young patients of various etiologies didn’t lose their relevance.Objective: Study of the peculiarities of approaches to intensive care in children with ICH. Material and methods: The medical documentation of 35 patients aged 21 days to 4 months with ICH of various etiologies from 2017 to 2021 was analyzed. Results: Due to the severity of their conditions, 83 % of patients required mechanical ventilation. In our case series of 29 children with vitamin K-deficient coagulopathy the mortality was 3.4 %. Cerebral vasospasm developed in 57.1 % of intracranial hemorrhage cases. The duration of stay in the intensive care unit and the duration of mechanical ventilation, in addition to the severity of the condition at admission, hemorrhagic shock and neurological deficit, were influenced by cerebral vasospasm and convulsive syndrome. Conclusion: A retrospective analysis of the results of the treatment of neonates with intracranial hemorrhages caused by a late form of HDN allowed us to identify factors affecting the severity of the condition and outcomes. Since the incidence of this severe pathology is relatively low, and the literature data are contradictory, the personal experience of each hospital is important.