Retinal hemorrhages in intubated pediatric intensive care patients

Susannah Q Longmuir; Lindsay McConnell; Resmiye Oral; Alina Dumitrescu; Sameer Kamath; Gwen Erkonen

doi:10.1016/j.jaapos.2013.12.005

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Retinal hemorrhages in intubated pediatric intensive care patients

Journal article

Peer reviewed

Retinal hemorrhages in intubated pediatric intensive care patients

Susannah Q Longmuir, Lindsay McConnell, Resmiye Oral, Alina Dumitrescu, Sameer Kamath and Gwen Erkonen

Journal of AAPOS, Vol.18(2), pp.129-133

04/2014

DOI: 10.1016/j.jaapos.2013.12.005

PMID: 24698608

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Abstract

To define the diagnoses associated with the presence of retinal hemorrhages, to clarify the association between retinal hemorrhages, cardiopulmonary resuscitation (CPR), and coagulopathy, and to describe the type of retinal hemorrhages found in intubated critically ill patients <4 years of age. This was a prospective observational study of intubated patients <4 years of age admitted to the pediatric intensive care unit of a tertiary care center from March 2010 to May 2012. The presence and description of retinal hemorrhages was recorded along with diagnoses, international normalized ratio (INR), CPR (in minutes), and mortality. A total of 85 intubated, critically ill patients (37 females) were included; average patient age was 8.2 months (range, 0.1-46.8 months). Of the 85 patients, 6 (7%) had retinal hemorrhages (95% CI, 0.029-0.153). Of the 6 patients with RH, abusive head trauma (AHT) was diagnosed in 4 patients, 1 patient had direct head trauma, and 1 had CPR. There were 8 patients with CPR out of the 85. AHT was highly associated with severe multilayered retinal hemorrhages (P = 0.0001) but coagulopathy (P = 0.2671) and CPR (P = 0.5342) were not. Severe multilayered retinal hemorrhages were associated with AHT in this cohort of patients. Without a history of trauma, retinal hemorrhages occurred in only 1 of 85 patients; in this case the hemorrhages were mild, confined to the posterior pole, and found only in the retinal layer.

Prevalence

Prospective Studies

Hospital Mortality

Humans

Child, Preschool

Craniocerebral Trauma - diagnosis

Infant

Male

Retinal Hemorrhage - epidemiology

Critical Illness - epidemiology

Intensive Care Units, Pediatric - statistics & numerical data

Retinal Hemorrhage - diagnosis

Intubation - statistics & numerical data

Female

Child Abuse - diagnosis

Details

Title: Subtitle: Retinal hemorrhages in intubated pediatric intensive care patients
Creators: Susannah Q Longmuir - Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa; Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address: Susannah-longmuir@uiowa.edu
Lindsay McConnell - Carver College of Medicine, Iowa City, Iowa
Resmiye Oral - Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Alina Dumitrescu - Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Sameer Kamath - Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Gwen Erkonen - Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Resource Type: Journal article
Publication Details: Journal of AAPOS, Vol.18(2), pp.129-133
Publisher: United States
DOI: 10.1016/j.jaapos.2013.12.005
PMID: 24698608
ISSN: 1091-8531
eISSN: 1528-3933
Language: English
Date published: 04/2014
Academic Unit: Stead Family Department of Pediatrics; Ophthalmology and Visual Sciences
Record Identifier: 9983980074902771

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