Details

Autor(en) / Beteiligte

• Pappas, Athina, MD
• Shankaran, Seetha, MD
• Laptook, Abbot R., MD
• Langer, John C., MS
• Bara, Rebecca, RN
• Ehrenkranz, Richard A., MD
• Goldberg, Ronald N., MD
• Das, Abhik, PhD
• Higgins, Rosemary D., MD
• Tyson, Jon E., MD, MPH
• Walsh, Michele C., MD, MS

Titel

Hypocarbia and Adverse Outcome in Neonatal Hypoxic-Ischemic Encephalopathy

Ist Teil von

• The Journal of pediatrics, 2011-05, Vol.158 (5), p.752-758.e1

Ort / Verlag

United States: Mosby, Inc

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective To evaluate the association between early hypocarbia and 18- to 22-month outcome among neonates with hypoxic-ischemic encephalopathy. Study design Data from the National Institute of Child Health and Human Development Neonatal Research Network randomized, controlled trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy were used for this secondary observational study. Infants (n = 204) had multiple blood gases recorded from birth to 12 hours of study intervention (hypothermia versus intensive care alone). The relationship between hypocarbia and outcome (death/disability at 18 to 22 months) was evaluated by unadjusted and adjusted analyses examining minimum PCO2 and cumulative exposure to PCO2 <35 mm Hg. The relationship between cumulative PCO2 <35 mm Hg (calculated as the difference between 35 mm Hg and the sampled PCO2 multiplied by the duration of time spent <35 mm Hg) and outcome was evaluated by level of exposure (none-high) using a multiple logistic regression analysis with adjustments for pH, level of encephalopathy, treatment group (±hypothermia), and time to spontaneous respiration and ventilator days; results were expressed as odds ratios and 95% confidence intervals. Alternative models of CO2 concentration were explored to account for fluctuations in CO2. Results Both minimum PCO2 and cumulative PCO2 <35 mm Hg were associated with poor outcome ( P < .05). Moreover, death/disability increased with greater cumulative exposure to PCO2 <35 mm Hg. Conclusions Hypocarbia is associated with poor outcome after hypoxic-ischemic encephalopathy.