生命早期的低碳酸血症与中重度新生儿脑病的脑损伤有关。
Hypocapnia in early hours of life is associated with brain injury in moderate to severe neonatal encephalopathy.
机构信息
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
出版信息
J Perinatol. 2022 Jul;42(7):892-897. doi: 10.1038/s41372-022-01398-2. Epub 2022 Apr 23.
OBJECTIVE
To evaluate the association between hypocapnia within the first 24 h of life and brain injury assessed by a detailed MRI scoring system in infants receiving therapeutic hypothermia (TH) for neonatal encephalopathy (NE) stratified by the stage of NE.
STUDY DESIGN
This retrospective cohort study included infants who received TH for mild to severe NE.
RESULTS
188 infants were included in the study with 48% having mild and 52% moderate-severe NE. Infants with moderate-severe NE spent more time in hypocapnia (PCO ≤ 35 mmHg) and presented with more severe brain injury on MRI compared to mild cases. The MRI injury score increased by 6% for each extra hour spent in hypocapnic range in infants with moderate-severe NE. There was no association between hypocapnia and injury scores in mild cases.
CONCLUSION
In infants with moderate-severe NE, the hours spent in hypocapnia was an independent predictor of brain injury.
目的
评估接受治疗性低体温（TH）的新生儿脑病（NE）婴儿在生命的头 24 小时内发生低碳酸血症与通过详细 MRI 评分系统评估的脑损伤之间的关系，并按 NE 的阶段进行分层。
研究设计
本回顾性队列研究纳入了接受 TH 治疗轻度至重度 NE 的婴儿。
结果
研究纳入了 188 名婴儿，其中 48%为轻度，52%为中重度 NE。与轻度病例相比，中重度 NE 婴儿的低碳酸血症（PCO≤35mmHg）时间更长，MRI 上的脑损伤更严重。中重度 NE 婴儿每额外处于低碳酸血症范围内 1 小时，MRI 损伤评分增加 6%。在轻度病例中，低碳酸血症与损伤评分之间无关联。
结论
在中重度 NE 婴儿中，低碳酸血症持续时间是脑损伤的独立预测因子。
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