Kaempf J W, Campbell B, Brown A, Bowers K, Gallegos R, Goldsmith J P
Providence St Vincent Medical Center, Neonatal Intensive Care Unit, Portland, OR 97225, USA.
J Perinatol. 2008 Jan;28(1):48-54. doi: 10.1038/sj.jp.7211859. Epub 2007 Nov 22.
To determine the capillary partial pressure of carbon dioxide (PCO(2)) and room air transcutaneous hemoglobin saturation (RA SAT) at 36 weeks' postmenstrual age (PMA) in infants born with weight between 501 and 1250 g.
Multicenter, prospective investigation with primary data collection within 72 h of 36 weeks PMA or discharge, whichever first. PCO(2) and RA SAT determinations were done at rest on infants not requiring mechanical ventilation or nasal continuous positive airway pressure (NCPAP).
A total of 220 infants were enrolled (mean gestational age 27.7 weeks, mean birthweight 951 g). In infants with traditionally defined chronic lung disease (CLD) compared to those without CLD, the mean PCO(2) was significantly higher (54 versus 45 mm Hg) and the median RA SAT significantly lower (<80 versus 97%). In infants with the new classification of bronchopulmonary dysplasia (BPD), there was a significant linear trend toward increasing PCO(2) with increasing severity of BPD (45, 47, 54 and 62 mm Hg in No, Mild, Moderate and Severe BPD). There was a significant linear trend toward decreasing RA SAT with increasing severity of BPD (97, 95 <80, <80% in No, Mild, Moderate and Severe BPD).
Defining CLD as BPD based upon a RA SAT test is a more discriminate, objective method to categorize lung injury. PCO(2) is an objective measure of lung function that inversely correlates with RA SAT. These determinations done together at 36 weeks PMA may provide more precise and accurate estimates of lung injury that might allow for better understanding of pulmonary therapies and clearer comparison of BPD rates and severities among NICUs.
确定出生体重在501至1250克之间的婴儿在孕龄36周时的毛细血管二氧化碳分压（PCO₂）和室内空气经皮血红蛋白饱和度（RA SAT）。
多中心前瞻性研究，在孕龄36周或出院后72小时内（以先到者为准）收集原始数据。对不需要机械通气或鼻持续气道正压通气（NCPAP）的婴儿在静息状态下进行PCO₂和RA SAT测定。
共纳入220例婴儿（平均胎龄27.7周，平均出生体重951克）。与无传统定义的慢性肺病（CLD）的婴儿相比，有CLD的婴儿平均PCO₂显著更高（54对45毫米汞柱），RA SAT中位数显著更低（<80%对97%）。在新分类的支气管肺发育不良（BPD）婴儿中，随着BPD严重程度增加，PCO₂有显著的线性上升趋势（无、轻度、中度和重度BPD分别为45、47、54和62毫米汞柱）。随着BPD严重程度增加，RA SAT有显著的线性下降趋势（无、轻度、中度和重度BPD分别为97%、95%、<80%、<80%）。
基于RA SAT测试将CLD定义为BPD是一种更具区分性、客观性的肺损伤分类方法。PCO₂是肺功能的客观指标，与RA SAT呈负相关。在孕龄36周时同时进行这些测定可能会提供更精确、准确的肺损伤评估，有助于更好地理解肺部治疗，并更清晰地比较各新生儿重症监护病房（NICU）的BPD发生率和严重程度。
