Thome, Ulrich H. and Dreyhaupt, Jens and Genzel-Boroviczeny, Orsolya and Bohnhorst, Bettina and Schmid, Manuel and Fuchs, Hans and Rohde, Oliver and Avenarius, Stefan and Topf, Hans-Georg and Zimmermann, Andrea and Faas, Dirk and Timme, Katharina and Kleinlein, Barbara and Buxmann, Horst and Schenk, Wilfried and Segerer, Hugo and Teig, Norbert and Ackermann, Benjamin and Hentschel, Roland and Heckmann, Matthias and Schloesser, Rolf and Peters, Jochen and Rossi, Rainer and Rascher, Wolfgang and Boettger, Ralf and Seidenberg, Juergen and Hansen, Gesine and Bode, Harald and Zernickel, Maria and Muches, Rainer and Hummler, Helmut D. (2018) Influence of PCO2 Control on Clinical and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants. NEONATOLOGY, 113 (3). pp. 221-230. ISSN 1661-7800, 1661-7819
Full text not available from this repository. (Request a copy)Abstract
Background: Levels or fluctuations in the partial pressure of CO2 (PCO2) may affect outcomes for extremely low birth weight infants. Objectives: In an exploratory analysis of a randomized trial, we hypothesized that the PCO2 values achieved could be related to significant outcomes. Methods: On each treatment day, infants were divided into 4 groups: relative hypocapnia, normocapnia, hypercapnia, or fluctuating PCO2. Ultimate assignment to a group for the purpose of this analysis was made according to the group in which an infant spent the most days. Statistical analyses were performed with analysis of variance (ANOVA), the Kruskal- Wallis test, the X-2 test, and the Fisher exact test as well as by multiple logistic regression. Results: Of the 359 infants, 57 were classified as hypocapnic, 230 as normocapnic, 70 as hypercapnic, and 2 as fluctuating PCO2. Hypercapnic infants had a higher average product of mean airway pressure and fraction of inspired oxygen (MAP x FiO(2)). For this group, mortality was higher, as was the likelihood of having moderate/severe bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and poorer neurodevelopment. Multiple logistic regression analyses showed an increased risk for BPD or death associated with birth weight (p < 0.001) and MAP x FiO(2) (p < 0.01). The incidence of adverse neurodevelopment was associated with birth weight (p < 0.001) and intraventricular hemorrhage (IVH; p < 0.01). Conclusions: Birth weight and respiratory morbidity, as measured by MAP x FiO(2), were the most predictive of death or BPD and NEC, whereas poor neurodevelopmental outcome was associated with low birth weight and IVH. Univariate models also identified PCO2. Thus, hypercapnia seems to reflect greater disease severity, a likely contributor to differences in outcomes. (C) 2018 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTREMELY PRETERM INFANTS; SEVERE INTRAVENTRICULAR HEMORRHAGE; BRONCHOPULMONARY DYSPLASIA; HYPERCAPNIC ACIDOSIS; PRESSURE; FLUCTUATIONS; OXYGENATION; SURFACTANT; TARGETS; PHELBI; Neurodevelopmental outcome; Permissive hypercapnia; Bayley scales; Bronchopulmonary dysplasia; Intraventricular hemorrhage |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Kinder- und Jugendmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2020 05:50 |
| Last Modified: | 23 Mar 2020 05:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15405 |
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