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Washington University Experience | VASCULAR | Hemorrhage - Neonatal | 29A0 Case 29 History
Case 29 History ---- The patient was a 2-month-old male infant born at an estimated gestational age of 41 weeks via spontaneous vaginal delivery to a G2P1 mother. Delivery was complicated by an at home birth and reported meconium aspiration resulting thereafter in respiratory distress and pneumomediastinum seen on chest xray. The patient was hospitalized at SLCH for two months and had a complicated course with respiratory failure attributed to meconium aspiration syndrome resulting in severe pulmonary hypertension requiring ECMO on day 4 of life. He subsequently developed respiratory failure and opacification of both lungs on imaging complicated by repeated pulmonary hemorrhage and pneumonia with several bacterial organisms. Head ultrasound on September 2nd showed intraventricular hemorrhage accompanied by multiple seizures. Blood cultures showed persistent methicillin-resistant Staphylococcus epidermis bacteremia starting on October 7th. He developed a right tension pneumothorax with midline shift that affected cardiac hemodynamics and resulted in intermittent bradycardia. After goals of care discussion with the clinical team, his family made the decision to stop further life-sustaining measures. He died on October 29th.
