May Caroline, Patel Sabina, Peacock Janet, Milner Anthony, Rafferty Gerrard F, Greenough Anne
Division of Asthma, Allergy, and Biology, King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, London, UK.
Pediatr Res. 2007 Apr;61(4):474-8. doi: 10.1203/pdr.0b013e3180332bfe.
Bronchopulmonary dysplasia (BPD) is associated with an early inflammatory response that persists after the first week of life. Inflammatory mediators can induce hemoxygenase-1 with a consequent increase in carbon monoxide (CO) production. End-tidal CO (ETCO) levels would be elevated in infants developing BPD. Serial measurements of ETCO levels were attempted on d 3, 5, 7, 14, 21, and 28 in 50 prematurely born infants (median gestational age 29 wk). Fourteen infants developed BPD [oxygen dependent beyond 36 wk post-menstrual age (PMA)] and had higher ETCO levels compared with the rest of the cohort on d 7, 14, 21, and 28. On d 14, the mean (SD) ETCO levels of the BPD group were 3.19 (1.11) ppm and 1.43 (0.61) ppm in the non-BPD group (p<0.001). An ETCO level on d 14>2.15 ppm had a sensitivity of 80% and specificity of 92% in predicting oxygen dependency at 36 wk PMA. Measurement of ETCO levels in prematurely born infants may be useful in the prediction of BPD.
支气管肺发育不良（BPD）与出生后第一周后仍持续存在的早期炎症反应相关。炎症介质可诱导血红素加氧酶-1，从而导致一氧化碳（CO）生成增加。患BPD的婴儿呼气末CO（ETCO）水平会升高。对50例早产儿（中位胎龄29周）在出生后第3、5、7、14、21和28天尝试进行ETCO水平的系列测量。14例婴儿发生了BPD[月经龄（PMA）36周后仍依赖氧气]，在第7、14、21和28天，其ETCO水平高于队列中的其他婴儿。在第14天，BPD组的平均（标准差）ETCO水平为3.19（1.11）ppm，非BPD组为1.43（0.61）ppm（p<0.001）。在预测PMA 36周时的氧气依赖情况方面，第14天ETCO水平>2.15 ppm的敏感度为80%，特异度为92%。测量早产儿的ETCO水平可能有助于预测BPD。
