Original Article

Journal of Perinatology (2006) 26, 279–285. doi:10.1038/sj.jp.7211492; published online 23 March 2006

Hypercapnia during the first 3 days of life is associated with severe intraventricular hemorrhage in very low birth weight infants

J R Kaiser1, C H Gauss2, M M Pont1 and D K Williams3

  1. 1Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  2. 2Department of Biostatistics, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  3. 3Division of Biostatistics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Correspondence: Dr JR Kaiser, Arkansas Children's Hospital, 800 Marshall Street, 512-5, Little Rock, AR 72202, USA. E-mail: kaiserjeffreyr@uams.edu

Received 18 October 2005; Revised 16 February 2006; Accepted 21 February 2006; Published online 23 March 2006.

Top

Abstract

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).

Study design:

 

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 less than or equal to3), multifetal gestation, vasopressor use, and maximum PaCO2.

Conclusion:

 

In addition to traditional risk factors, it appears maximum PaCO2 is a dose-dependent predictor of severe IVH during the permissive hypercapnia era.

Keywords:

hypercapnia, intraventricular hemorrhage, carbon dioxide, very low birth weight infant

Extra navigation

.

naturejobs

More science jobs
Post a job for free
ADVERTISEMENT