Do hyperoxaemia and hypocapnia add to the risk of brain injury after intrapartum asphyxia?

Klinger, G.; Beyene, J.; Shah, P.; Perlman, M.
January 2005
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jan2005, Vol. 90 Issue 1, pF49
Academic Journal
Background: Episodes of hyperoxaemia and hypocapnia, which may contribute to brain injury, occur unintentionally in severely asphyxiated neonates in the first postnatal hours. Objective: To determine whether hyperoxaemia and/or hypocapnia during the first 2 hours of life add to the risk of brain injury after intrapartum asphyxia. Methods: Retrospective cohort study in term infants with post-asphyxial hypoxic ischaemic encephalopathy (HIE) born between 1985 and 1995. Severe and moderate hyperoxaemia were defined as PaO2 > 26.6 and PaO2 >13.3 kPa (200 and 100 mm Hg). Severe and moderate hypocapnia were defined as PaCO2 < 2.6 and PaCO2 < 3.3 kPa (20 and 25 mm Hg). Adverse outcome ascertained by age 24 months was defined as death, severe cerebral palsy, or any cerebral palsy with blindness, deafness, or developmental delay. With outcome as the dependent variable, multivariate analyses were performed including hyperoxaemic and hypocapnic variables, and factors adjusted for initial disease severity. Results: Of 244 infants, 218 had known outcomes, 127 of which were adverse (64 deaths, 63 neurodevelopmental deficits). Multivariate analyses showed an association between adverse outcome and episodes of severe hyperoxaemia (odds ratio (OR) 3.85, 95% confidence interval (Cl) 1 .67 to 8.88, p = 0.002), and severe hypocapnia (OR 2.34, 95% Cl 1.02 to 5.37, p = 0.044). The risk of adverse outcome was highest in infants who had both severe hyperoxaemia and severe hypocapnia (OR 4.56, 95% Cl 1.4 to 14.9, p = 0.012). Conclusions: Severe hyperoxaemia and severe hypocapnia were associated with adverse outcome in infants with post-asphyxial HIE. During the first hours of life, oxygen supplementation and ventilation should be rigorously controlled.


Related Articles

  • Immature Mouse Unilateral Carotid Ligation Model of Stroke. Comi, Anne M.; Johnston, Michael V.; Wilson, Mary Ann // Journal of Child Neurology;Dec2005, Vol. 20 Issue 12, p980 

    Cerebral palsy in humans results from a diverse group of disorders that produce nonprogressive motor impairments in the developing brain. Stroke is an important cause of hemiparetic cerebral palsy in neonates and young children. We recently developed a new immature mouse model of stroke that...

  • Process Diary as Methodological Approach in Longitudinal Phenomenological Research. Woll, Heidi // Indo-Pacific Journal of Phenomenology;Oct2013, Vol. 13 Issue 2, p1 

    This article focuses on the process diary as a qualitative instrument in phenomenological research. The first part of the article provides a brief historical review on the use of diaries in social and health research. The second part of the article presents an example of how the process diary...

  • Development of a Novel Orofacial Motor Function Assessment Scale for Children With Cerebral Palsy. Botti Rodrigues Santos, Maria Teresa; Scalco Manzano, Felipe; Duarte Ferreira, Maria Cristina; Masiero, Danilo // Journal of Dentistry for Children;Sep-Dec2005, Vol. 72 Issue 3, p113 

    Purpose: The aim of this study was to develop the orofacial motor function assessment scale (OFMFAS) and appraise its performance in terms of validity and reliability in a cohort of 116 cerebral palsy patients. Methods: The scale was developed according to a process derived from the theory of...

  • Cerebral Palsy and Minor Congenital Anomalies. Miller, Geoffrey // Clinical Pediatrics;Feb1991, Vol. 30 Issue 2, p97 

    Offers observation on cerebral palsy (CP) and minor congenital anomalies (MCA). Factors that are attributed by many clinicians and non-medical personnel as the cause of CP; Discussion on MCA; Explanation on the association between parturitional difficulties and CP influences.

  • Validity of gait parameters for hip flexor contracture in patients with cerebral palsy. Sun Jong Choi; Chin Youb Chung; Kyoung Min Lee; Dae Gyu Kwon; Sang Hyeong Lee; Moon Soek Park // Journal of NeuroEngineering & Rehabilitation (JNER);2011, Vol. 8 Issue 1, p4 

    Background: Psoas contracture is known to cause abnormal hip motion in patients with cerebral palsy. The authors investigated the clinical relevance of hip kinematic and kinetic parameters, and 3D modeled psoas length in terms of discriminant validty, convergent validity, and responsiveness....

  • Exercise Adherence and Teens With Spastic Cerebral Palsy.  // Adapted Physical Activity Quarterly;Oct2005, Vol. 22 Issue 4, p424 

    The section presents the abstract, Factors influencing adherence to a home-based strength-training programme for young people with cerebral palsy, by N. F. Taylor.

  • Developmental outcome of the use of etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial. Schulte, J.; Osborne, J.; Benson, J. W. T.; Cooke, R.; Drayton, M.; Murphy, J.; Rennie, J.; Speicle, B. D. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jan2005, Vol. 90 Issue 1, pF31 

    Objective: To compare neurodevelopmental outcome of survivors of the multicentre trial of etamsylate (the iRNN for ethamsylate) for prevention of periventricular haemorrhage in very low birthweight infants. Design: Double blind, single observer, prospective follow up of placebo controlled study....

  • Causal Mechanisms Underlying Periventricular Leukomalacia and Cerebral Palsy. Kadhim, Hazim; S�bire, Guillaume; Kahn, Andr�; Evrard, Philippe; Dan, Bernard // Current Pediatric Reviews;2005, Vol. 1 Issue 1, p1 

    Periventricular leukomalacia is a major neuropathological substrate underlying most of the neurologic morbidity in cerebral palsy. Etiopathogenesis of periventricular leukomalacia is believed to be multifactorial, involving hypoxic-ischemic insults and inflammatory processes. While emphasis was...

  • SURGICAL PATHOLOGY AND TREATMENT OF COMPLICATED CEREBRAL PALSY. Rosner, Samuel // Angiology;Feb1966, Vol. 17 Issue 2, p77 

    Discusses the pathology and treatment of complicated cerebral palsy. Symptoms of cerebral birth palsy; Number of patients who were examined at surgery; Bases for the operation of cerebral palsy.


Read the Article


Sign out of this library

Other Topics