Influence of PCO2 Control on Clinical and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: Thome UH, Dreyhaupt J, Genzel-Boroviczeny O, Bohnhorst B, Schmid M, Fuchs H, Rohde O, Avenarius S, Topf HG, Zimmermann A, Faas D, Timme K, Kleinlein B, Buxmann H, Schenk W, Segerer H, Teig N, Ackermann B, Hentschel R, Heckmann M, Schloesser R, Peters J, Rossi R, Rascher W, Boettger R, Seidenberg J, Hansen G, Bode H, Zernickel M, Muches R, Hummler HD
Zeitschrift: Neonatology
Jahr der Veröffentlichung: 2018
Band: 113
Heftnummer: 3
Seitenbereich: 221-230
ISSN: 1661-7800


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 χ2 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 × FiO2). 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 × FiO2 (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 × FiO2, 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.


FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Rascher, Wolfgang Prof. Dr. med.
Kinder- und Jugendklinik


Einrichtungen weiterer Autorinnen und Autoren

Albert-Ludwigs-Universität Freiburg
Carl von Ossietzky Universität Oldenburg
Goethe-Universität Frankfurt am Main
Justus-Liebig-Universität Gießen
Klinikum Augsburg
Ludwig-Maximilians-Universität (LMU)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Otto-von-Guericke-Universität Magdeburg
Ruhr-Universität Bochum (RUB)
Technische Universität München (TUM)
Universität Greifswald
Universität Leipzig
Universität Regensburg
Universität Ulm
Vivantes - Netzwerk für Gesundheit GmbH


Zitierweisen

APA:
Thome, U.H., Dreyhaupt, J., Genzel-Boroviczeny, O., Bohnhorst, B., Schmid, M., Fuchs, H.,... Hummler, H.D. (2018). Influence of PCO2 Control on Clinical and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants. Neonatology, 113(3), 221-230. https://dx.doi.org/10.1159/000485828

MLA:
Thome, Ulrich H., et al. "Influence of PCO2 Control on Clinical and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants." Neonatology 113.3 (2018): 221-230.

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Zuletzt aktualisiert 2019-27-02 um 10:08