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• W2215805726 abstract "<h3>Objective</h3> To determine the association of arterial partial pressure of carbon dioxide PaCO₂ with severe intraventricular haemorrhage (sIVH), bronchopulmonary dysplasia (BPD), and neurodevelopmental impairment (NDI) at 18–22 months in premature infants. <h3>Design</h3> Secondary exploratory data analysis of Surfactant, Positive Pressure, and Oxygenation Randomised Trial (SUPPORT). <h3>Setting</h3> Multiple referral neonatal intensive care units. <h3>Patients</h3> 1316 infants 24 0/7 to 27 6/7 weeks gestation randomised to different oxygenation (SpO₂ target 85–89% vs 91–95%) and ventilation strategies. <h3>Main outcome measures</h3> Blood gases from postnatal day 0 to day14 were analysed. Five PaCO₂ variables were defined: minimum (Min), maximum (Max), SD, average (time-weighted), and a four level categorical variable (hypercapnic (highest quartile of Max PaCO₂), hypocapnic (lowest quartile of Min PaCO₂), fluctuators (hypercapnia and hypocapnia), and normocapnic (middle two quartiles of Max and Min PaCO₂)). PaCO₂ variables were compared for infants with and without sIVH, BPD and NDI (±death). Multivariable logistic regression models were developed for adjusted results. <h3>Results</h3> sIVH, BPD and NDI (±death) were associated with hypercapnic infants and fluctuators. Association of Max PaCO₂ and outcomes persisted after adjustment (per 10 mm Hg increase: sIVH/death: OR 1.27 (1.13 to 1.41); BPD/death: OR 1.27 (1.12 to 1.44); NDI/death: OR 1.23 (1.10 to 1.38), death: OR 1.27 (1.12 to 1.44), all p<0.001). No interaction was found between PaCO₂ category and SpO₂ treatment group for sIVH/death, NDI/death or death. Max PaCO₂ was positively correlated with maximum FiO₂ (r_s0.55, p<0.0001) and ventilator days (r_s0.61, p<0.0001). <h3>Conclusions</h3> Higher PaCO₂ was an independent predictor of sIVH/death, BPD/death and NDI/death. Further trials are needed to evaluate optimal PaCO₂ targets for high-risk infants." @default.
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• W2215805726 date "2014-11-25" @default.
• W2215805726 modified "2023-09-25" @default.
• W2215805726 title "PaCO₂in Surfactant, Positive Pressure, and Oxygenation Randomised Trial (SUPPORT)" @default.
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• W2215805726 doi "https://doi.org/10.1136/archdischild-2014-306802" @default.
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