The Relation between Hypocarbia and Periventricular Leukomalacia in Preterm Infants with Mechanical Ventilation.

Park,  Eun Hye; Namgung,  Ran; Park,  Min Soo; Park,  Kook In; Kim,  Myung Joon; Lee,  Chul

Original Article

Journal of the Korean Society of Neonatology 2002;9(2):150-158.
Published online November 1, 2002.

The Relation between Hypocarbia and Periventricular Leukomalacia in Preterm Infants with Mechanical Ventilation.

Eun Hye Park, Ran Namgung, Min Soo Park, Kook In Park, Myung Joon Kim, Chul Lee

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. ranng@yumc.yonsei.ac.kr
²Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.

기계적 환기요법을 시행받은 미숙아에서 저탄산혈증과 뇌실주위 백질연화증의 발생과의 관계

^, ^, ^, ^, ^,

^¹
^²

Abstract

PURPOSE
To investigate whether hypocarbia during the first 3 days of life plays a role in the development of periventricular leukomalacia (PVL) in preterm infants with mechanical ventilation.
METHODS
The medical records were reviewed for 19 infants with PVL and 38 with normal neurosonogram who were born before 37 weeks' gestation and who required mechanical ventilation during the first 3 days of life. The patients' characteristics, antenatal and neonatal variables were compared. The CO2 index, TA (time-averaged)-PaCO2, TA-PaO2 and TA-pH were calculated within the first 72 hours of life. The TA-FiO2, TA-respiratory rate (RR), TA-peak inspiratory pressure (PIP), TA-mean airway pressure (MAP) and TA-ventilator index (VI) were also calculated.
RESULTS
No significant difference was observed in the clinical characteristics or neonatal variables except hyaline membrane disease (42% in PVL group vs 81% in control group)(P=0.0025). There were no significant differences in CO2 index, TA-PaCO2 and TA- PaO2 between groups. The TA-pH was lower in infants with PVL (7.33+/-0.06) than in control group (7.37+/-0.05) (P=0.035). The TA-FiO2, TA-RR, TA-PIP, TA-MAP and TA- VI of two groups showed no significant differences.
CONCLUSION
Partial pressure of arterial carbon dioxide during the first 3 days of life was not associated with the subsequent development of PVL. The compound effects of other risk factors including systemic pH may be important in the development of PVL in preterm infants.

Key Words: Periventricular leukomalacia; Hypocarbia; Mechanical ventilation