Kaiser J R, Gauss C H, Pont M M, Williams D K
Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 72202, USA.
J Perinatol. 2006 May;26(5):279-85. doi: 10.1038/sj.jp.7211492.
To examine whether hypercapnia in very low birth weight (VLBW) infants during the first 3 days of life is associated with severe intraventricular hemorrhage (IVH).
Retrospective cohort study of inborn VLBW infants between January 1999 and May 2004 with arterial access during the first 3 days of life. A multiple logistic regression analysis was used where IVH was dichotomized ((grades 0/1/2) = non-severe; (grades 3/4) = severe). Measures of hypercapnia were entered into the model to ascertain their association with severe IVH.
In total, 574 VLBW infants met entry criteria. Worst IVH grade was 0 in 400; 1: 54; 2: 42; 3: 47; and 4: 31 infants. The logistic regression model consisted of the following predictors of severe IVH: gestational age, gender, 1 min Apgar score (dichotomized into two groups: >3 vs < or =3), multifetal gestation, vasopressor use, and maximum PaCO(2).
In addition to traditional risk factors, it appears maximum PaCO(2) is a dose-dependent predictor of severe IVH during the permissive hypercapnia era.
探讨极低出生体重（VLBW）婴儿出生后3天内的高碳酸血症是否与严重脑室内出血（IVH）相关。
对1999年1月至2004年5月期间出生的VLBW婴儿进行回顾性队列研究，这些婴儿在出生后3天内有动脉通路。采用多因素logistic回归分析，将IVH分为两类（0/1/2级 = 非严重；3/4级 = 严重）。将高碳酸血症的测量指标纳入模型，以确定它们与严重IVH的关联。
共有574名VLBW婴儿符合纳入标准。IVH最严重等级为0级的有400名婴儿；1级：54名；2级：42名；3级：47名；4级：31名。logistic回归模型包括以下严重IVH的预测因素：胎龄、性别、1分钟阿氏评分（分为两组：>3分与≤3分）、多胎妊娠、血管升压药使用情况以及最高动脉血二氧化碳分压（PaCO₂）。
在允许性高碳酸血症时代，除了传统危险因素外，最高PaCO₂似乎是严重IVH的剂量依赖性预测因素。
