Skip to main content
Journal cover image

Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy.

Publication ,  Journal Article
Pappas, A; Shankaran, S; Laptook, AR; Langer, JC; Bara, R; Ehrenkranz, RA; Goldberg, RN; Das, A; Higgins, RD; Tyson, JE; Walsh, MC ...
Published in: J Pediatr
May 2011

OBJECTIVE: To evaluate the association between early hypocarbia and 18- to 22-month outcome among neonates with hypoxic-ischemic encephalopathy. STUDY DESIGN: Data from the National Institute of Child Health and Human Development Neonatal Research Network randomized, controlled trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy were used for this secondary observational study. Infants (n = 204) had multiple blood gases recorded from birth to 12 hours of study intervention (hypothermia versus intensive care alone). The relationship between hypocarbia and outcome (death/disability at 18 to 22 months) was evaluated by unadjusted and adjusted analyses examining minimum PCO(2) and cumulative exposure to PCO(2) <35 mm Hg. The relationship between cumulative PCO(2) <35 mm Hg (calculated as the difference between 35 mm Hg and the sampled PCO(2) multiplied by the duration of time spent <35 mm Hg) and outcome was evaluated by level of exposure (none-high) using a multiple logistic regression analysis with adjustments for pH, level of encephalopathy, treatment group (± hypothermia), and time to spontaneous respiration and ventilator days; results were expressed as odds ratios and 95% confidence intervals. Alternative models of CO(2) concentration were explored to account for fluctuations in CO(2). RESULTS: Both minimum PCO(2) and cumulative PCO(2) <35 mm Hg were associated with poor outcome (P < .05). Moreover, death/disability increased with greater cumulative exposure to PCO(2) <35 mm Hg. CONCLUSIONS: Hypocarbia is associated with poor outcome after hypoxic-ischemic encephalopathy.

Duke Scholars

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2011

Volume

158

Issue

5

Start / End Page

752 / 758.e1

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Pediatrics
  • Male
  • Infant, Newborn
  • Hypoxia-Ischemia, Brain
  • Hypothermia, Induced
  • Hypocapnia
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pappas, A., Shankaran, S., Laptook, A. R., Langer, J. C., Bara, R., Ehrenkranz, R. A., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2011). Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy. J Pediatr, 158(5), 752-758.e1. https://doi.org/10.1016/j.jpeds.2010.10.019
Pappas, Athina, Seetha Shankaran, Abbot R. Laptook, John C. Langer, Rebecca Bara, Richard A. Ehrenkranz, Ronald N. Goldberg, et al. “Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy.J Pediatr 158, no. 5 (May 2011): 752-758.e1. https://doi.org/10.1016/j.jpeds.2010.10.019.
Pappas A, Shankaran S, Laptook AR, Langer JC, Bara R, Ehrenkranz RA, et al. Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy. J Pediatr. 2011 May;158(5):752-758.e1.
Pappas, Athina, et al. “Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy.J Pediatr, vol. 158, no. 5, May 2011, pp. 752-758.e1. Pubmed, doi:10.1016/j.jpeds.2010.10.019.
Pappas A, Shankaran S, Laptook AR, Langer JC, Bara R, Ehrenkranz RA, Goldberg RN, Das A, Higgins RD, Tyson JE, Walsh MC, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Hypocarbia and adverse outcome in neonatal hypoxic-ischemic encephalopathy. J Pediatr. 2011 May;158(5):752-758.e1.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2011

Volume

158

Issue

5

Start / End Page

752 / 758.e1

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Survival Rate
  • Pediatrics
  • Male
  • Infant, Newborn
  • Hypoxia-Ischemia, Brain
  • Hypothermia, Induced
  • Hypocapnia
  • Humans