Both extremes of arterial carbon dioxide pressure and the magnitude of fluctuations in arterial carbon dioxide pressure are associated with severe intraventricular hemorrhage in preterm infants

Academic Article

Abstract

  • OBJECTIVE. The goal was to test the hypothesis that extremes of PaCO during the first 4 days after birth are associated with severe intraventricular hemorrhage (grades 3 and 4). METHODS. A single-center retrospective review of clinical and blood gas data in the first 4 postnatal days for 849 infants with birth weights of 401 to 1250 g was performed. The univariate and multivariate relationships of severe intraventricular hemorrhage with maximal and minimal PaCO , PaCO averaged over time (time-weighted PaCO ), and measures of PaCO fluctuation (SD of PaCO and difference in PaCO [maximum minus minimum]) were assessed. RESULTS. Birth weight (mean ± SD) was 848 ± 212 g, and the median gestational age was 26 weeks. Infants with severe intraventricular hemorrhage had higher maximal PaCO (median: 72 vs 59 mm Hg) and time-weighted PaCO (mean: 49 vs 47 mmHg) values but lower minimal PaCO values (32 vs 37mmHg). High PaCO , low PaCO , SD of PaCO , and difference in PaCO predicted severe intraventricular hemorrhage, but time-weighted average PaCO was not as predictive. CONCLUSIONS. Both extremes and fluctuations of PaCO are associated with severe intraventricular hemorrhage. It may be prudent to avoid extreme hypocapnia and hypercapnia during the period of risk for intraventricular hemorrhage. Copyright © 2007 by the American Academy of Pediatrics. 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
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    Digital Object Identifier (doi)

    Author List

  • Fabres J; Carlo WA; Phillips V; Howard G; Ambalavanan N
  • Start Page

  • 299
  • End Page

  • 305
  • Volume

  • 119
  • Issue

  • 2