Do hyperoxaemia and hypocapnia add to the risk of brain injury after intrapartum asphyxia?
Open Access
- 1 January 2005
- journal article
- research article
- Published by BMJ in Archives of Disease in Childhood: Fetal & Neonatal
- Vol. 90 (1), F49-F52
- https://doi.org/10.1136/adc.2003.048785
Abstract
Background: Episodes of hyperoxaemia and hypocapnia, which may contribute to brain injury, occur unintentionally in severely asphyxiated neonates in the first postnatal hours. Objective: To determine whether hyperoxaemia and/or hypocapnia during the first 2 hours of life add to the risk of brain injury after intrapartum asphyxia. Methods: Retrospective cohort study in term infants with post-asphyxial hypoxic ischaemic encephalopathy (HIE) born between 1985 and 1995. Severe and moderate hyperoxaemia were defined as Pao2 >26.6 and Pao2 >13.3 kPa (200 and 100 mm Hg). Severe and moderate hypocapnia were defined as Paco2 2 Results: Of 244 infants, 218 had known outcomes, 127 of which were adverse (64 deaths, 63 neurodevelopmental deficits). Multivariate analyses showed an association between adverse outcome and episodes of severe hyperoxaemia (odds ratio (OR) 3.85, 95% confidence interval (CI) 1.67 to 8.88, p = 0.002), and severe hypocapnia (OR 2.34, 95% CI 1.02 to 5.37, p = 0.044). The risk of adverse outcome was highest in infants who had both severe hyperoxaemia and severe hypocapnia (OR 4.56, 95% CI 1.4 to 14.9, p = 0.012). Conclusions: Severe hyperoxaemia and severe hypocapnia were associated with adverse outcome in infants with post-asphyxial HIE. During the first hours of life, oxygen supplementation and ventilation should be rigorously controlled.Keywords
This publication has 21 references indexed in Scilit:
- Probable adverse reaction to a pharmaceutical excipientArchives of Disease in Childhood: Fetal & Neonatal, 2004
- Oxygen at birth and prolonged cerebral vasoconstriction in preterm infants.Archives of Disease in Childhood: Fetal & Neonatal, 1995
- Carbon Dioxide Protects the Perinatal Brain From Hypoxic-Ischemic Damage: An Experimental Study in the Immature RatPediatrics, 1995
- Resuscitation of Asphyxic Newborn Infants with Room Air or 100% OxygenPediatric Research, 1993
- Cerebral Blood Flow Measurements in the Newborn DogNeonatology, 1993
- Response of the Cerebral Circulation to Hypocarbia in Postasphyxia Newborn LambsPediatric Research, 1992
- Mechanical Ventilation in Preterm Infants: Neurosonographic and Developmental StudiesPEDIATRICS, 1992
- Heterogeneity of cerebral vasoreactivity in preterm infants supported by mechanical ventilationThe Journal of Pediatrics, 1989
- The Role of Oxygen Free Radicals in Postasphyxia Cerebral Hypoperfusion in Newborn LambsPediatric Research, 1989
- Two patterns of perinatal brain damage and their conditions of occurrenceAmerican Journal of Obstetrics and Gynecology, 1972