Abstract
Flower, et. al. have reported that newborn animals made hypercarbic had both an increased incidence and severity of RLF. This study concerns data on 74 surviving infants with birth weights ≤ 1000 grams, half of whom (37 infants) had RLF diagnosed either while in hospital or shortly after discharge. Twenty eight independent variables were analyzed to determine their role in the occurrence of RLF. By discriminant analysis, 9 of these variables correlated with the development of RLF (r=.70) and accounted for 49% of the variance. The total function (nos. 1-9) yielded a Chi-square of p < .0007. This function would correctly predict infants with RLF 84% of the time. The component which best predicted the outcome was the highest PaCO2 measured in the infant (#1). The second most important variable was the total number of high PaCO2's (> 50 TORR) which occurred simultaneously with an elevated PaO2 (> 100 TORR). Other variables included the total number of PaO2's > 100 TORR (#3), the Apgar Score at 1 minute (#4), the Ponderal Index (#5), total days on CPAP (#6), the highest recorded PaO2 (#7), total respirator days (#8) and the Ponderal Index Percentile (#9). These data suggest that PaCO2 may be a very significant variable in the development of RLF. Retinal vasoconstriction, if viewed as protective, may be abolished by hypercarbia; thereby allowing free flow of potentially toxic hyperoxic blood into the retinal tissues. We suggest that continuous PaCO2 monitoring may be as important as PaCO2 monitoring in the prevention of RLF.
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Bauer, C., Widmayer, S. & Bancalari, E. 1236 A RELATIONSHIP BETWEEN PaCO2 AND RETROLENTAL FIBROPLASIA (RLF). Pediatr Res 15 (Suppl 4), 649 (1981). https://doi.org/10.1203/00006450-198104001-01263
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DOI: https://doi.org/10.1203/00006450-198104001-01263