title: Early blood gas abnormalities and the preterm brain.
abstract: The authors explored associations between blood gas abnormalities in more than 1,000 preterm infants during the first postnatal days and indicators of neonatal brain damage. During 2002-2004, women delivering infants before 28 weeks' gestation at one of 14 participating institutions in 5 US states were asked to enroll in the study. The authors compared infants with blood gas values in the highest or lowest quintile for gestational age and postnatal day (extreme value) on at least 1 of the first 3 postnatal days with the remainder of the subjects, with separate analyses for blood gas abnormalities on multiple days and for partial pressure of oxygen in the alveolar gas of <35. Outcomes analyzed were ventriculomegaly and an echolucent lesion on an ultrasound scan in the neonatal intensive care unit, and cerebral palsy, microcephaly, and a low score on a Bayley Scale of Infant Development at 24 months. Every blood gas derangement (hypoxemia, hyperoxemia, hypocapnia, hypercapnia, and acidosis) was associated with multiple indicators of brain damage. However, for some, the associations were seen with only 1 day of exposure; others were evident with 2 or more days' exposure. Findings suggest that individual blood gas derangements do not increase brain damage risk. Rather, the multiple derangements associated with indicators of brain damage might be indicators of immaturity/vulnerability and illness severity.
authors.affiliation: Neuroepidemiology Unit, Neurology Department, Children’s Hospital Boston, and Harvard Medical School, Boston, Massachusetts 02215-5724, USA. alan.leviton@childrens.harvard.edu
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allred
authors.forename: Karl C K
authors.initials: KC
authors.lastname: Kuban
authors.forename: Olaf
authors.initials: O
authors.lastname: Dammann
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.forename: Deborah
authors.initials: D
authors.lastname: Hirtz
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schreiber
authors.forename: Nigel
authors.initials: N
authors.lastname: Paneth
mesh_terms: D001784:Blood Gas Analysis; D001921:Brain / Q000098:blood supply*; D001930:Brain Injuries / Q000097:blood*; D002547:Cerebral Palsy / Q000097:blood; D002675:Child, Preschool; D004453:Echoencephalography; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood*; D014481:United States
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