Hypercapnia during the first 3 days of life is associated with severe intraventricular hemorrhage in very low birth weight infants.
OBJECTIVE
To examine whether hypercapnia in very low birth weight (VLBW) infants during the first 3 days of life is associated with severe intraventricular hemorrhage (IVH).


METHODS
Retrospective cohort study of inborn VLBW infants between January 1999 and May 2004 with arterial access during the first 3 days of life. A multiple logistic regression analysis was used where IVH was dichotomized ((grades 0/1/2) = non-severe; (grades 3/4) = severe). Measures of hypercapnia were entered into the model to ascertain their association with severe IVH.


RESULTS
In total, 574 VLBW infants met entry criteria. Worst IVH grade was 0 in 400; 1: 54; 2: 42; 3: 47; and 4: 31 infants. The logistic regression model consisted of the following predictors of severe IVH: gestational age, gender, 1 min Apgar score (dichotomized into two groups: >3 vs < or =3), multifetal gestation, vasopressor use, and maximum PaCO(2).


CONCLUSIONS
In addition to traditional risk factors, it appears maximum PaCO(2) is a dose-dependent predictor of severe IVH during the permissive hypercapnia era.
Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 72202, USA. kaiserjeffreyr@uams.edu
J R
JR
Kaiser
C H
CH
Gauss
M M
MM
Pont
D K
DK
Williams
D002543:Cerebral Hemorrhage / Q000209:etiology*; D002552:Cerebral Ventricles / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D006935:Hypercapnia / Q000150:complications*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors