Abstract
Hyperventilation has been advocated for treatment of newborn infants with pulmonary hypertension; however, there are theoretical harmful effects of hyperventilation on the immature nervous system. From March 1977 to May 1979, 13 infants > 37 weeks gestation were selected to be hyperventilated because of severe hypoxemia refractory to conventional mechanical ventilation, i.e., failure to maintain PaO2 > 50 torr with an FiO2 1.0, despite PaCO2 <40 and pH >7.40. Eleven survived, 9 were available for follow-up evaluation. Seven infants had meconium aspiration syndrome, one had HMD, one had Gp B strep sepsis. All infants eventually required a decrease in PaCO2 to <20 torr and increase, in pH to >7.50 before a change in AaDO2 became evident. As a group, the 9 infants were exposed to a PaCO2<20 torr for 51.8±11.8 hrs (mean±SEM), to PaCO2 <15 torr for 11.8±3.3 hrs, to a pH 7.50 for 64.4±18.6 hrs, and to a pH>7.60 for 6.1±2.9 hrs. One infant was lost to follow-up after a normal assessment at 9 mos. The other 8 infants (7 AGA, 1 markedly SGA) were at least 1¼ years at the time of evaluation. The 7 AGA infants had a normal developmental quotient (mean±110, range 96-130) by Stanford Binet or Bayley; the one SGA infant had a Bayley of 89. All 8 had normal neurological examinations. All AGA infants are growing normally. Although only 9 infants with short term follow-up are reported here, these preliminary oservations are reassuring with respect to neurological and developmental outcome following prolonged hyperventilation.
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Brett, C., Dekle, M., Leonard, C. et al. 1486 FOLLOW-UP OF HYPERVENTILATED NEONATES. Pediatr Res 15 (Suppl 4), 691 (1981). https://doi.org/10.1203/00006450-198104001-01515
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DOI: https://doi.org/10.1203/00006450-198104001-01515