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 PCO(2) and cumulative exposure to PCO(2) <35 mm Hg. The relationship between cumulative PCO(2) <35 mm Hg (calculated as the difference between 35 mm Hg and the sampled PCO(2) 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 CO(2) concentration were explored to account for fluctuations in CO(2). RESULTS: Both minimum PCO(2) and cumulative PCO(2) <35 mm Hg were associated with poor outcome (P < .05). Moreover, death/disability increased with greater cumulative exposure to PCO(2) <35 mm Hg. CONCLUSIONS: Hypocarbia is associated with poor outcome after hypoxic-ischemic encephalopathy.
RCT Entities:
OBJECTIVE: To evaluate the association between early hypocarbia and 18- to 22-month outcome among neonates with hypoxic-ischemicencephalopathy. 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-ischemicencephalopathy 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 PCO(2) and cumulative exposure to PCO(2) <35 mm Hg. The relationship between cumulative PCO(2) <35 mm Hg (calculated as the difference between 35 mm Hg and the sampled PCO(2) 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 CO(2) concentration were explored to account for fluctuations in CO(2). RESULTS: Both minimum PCO(2) and cumulative PCO(2) <35 mm Hg were associated with poor outcome (P < .05). Moreover, death/disability increased with greater cumulative exposure to PCO(2) <35 mm Hg. CONCLUSIONS: Hypocarbia is associated with poor outcome after hypoxic-ischemicencephalopathy.
Authors: Suresh Victor; Richard E Appleton; Margaret Beirne; Anthony G Marson; Alan M Weindling Journal: Pediatr Res Date: 2005-09 Impact factor: 3.756
Authors: A J du Plessis; R A Jonas; D Wypij; P R Hickey; J Riviello; D L Wessel; S J Roth; F A Burrows; G Walter; D M Farrell; A Z Walsh; C A Plumb; P del Nido; R P Burke; A R Castaneda; J E Mayer; J W Newburger Journal: J Thorac Cardiovasc Surg Date: 1997-12 Impact factor: 5.209
Authors: Seetha Shankaran; Abbot R Laptook; Richard A Ehrenkranz; Jon E Tyson; Scott A McDonald; Edward F Donovan; Avroy A Fanaroff; W Kenneth Poole; Linda L Wright; Rosemary D Higgins; Neil N Finer; Waldemar A Carlo; Shahnaz Duara; William Oh; C Michael Cotten; David K Stevenson; Barbara J Stoll; James A Lemons; Ronnie Guillet; Alan H Jobe Journal: N Engl J Med Date: 2005-10-13 Impact factor: 91.245
Authors: Allan R de Caen; Marc D Berg; Leon Chameides; Cheryl K Gooden; Robert W Hickey; Halden F Scott; Robert M Sutton; Janice A Tijssen; Alexis Topjian; Élise W van der Jagt; Stephen M Schexnayder; Ricardo A Samson Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Jennifer K Lee; Andrea Poretti; Jamie Perin; Thierry A G M Huisman; Charlamaine Parkinson; Raul Chavez-Valdez; Matthew O'Connor; Michael Reyes; Jillian Armstrong; Jacky M Jennings; Maureen M Gilmore; Raymond C Koehler; Frances J Northington; Aylin Tekes Journal: Dev Neurosci Date: 2016-12-16 Impact factor: 2.984
Authors: Susan E Jacobs; Marie Berg; Rod Hunt; William O Tarnow-Mordi; Terrie E Inder; Peter G Davis Journal: Cochrane Database Syst Rev Date: 2013-01-31