Cerebral Vascular Responses to Changes in Carbon Dioxide Tension in Term and Preterm Infants with Apnea

Neonatology ◽  
2003 ◽  
Vol 84 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Anne Koons ◽  
Thomas Hegyi ◽  
Rajeev Mehta ◽  
Mark Hiatt ◽  
Barry Weinberger
Keyword(s):  
Carbon Dioxide ◽  
Preterm Infants ◽  
Carbon Dioxide Tension ◽  
Vascular Responses ◽  
Cerebral Vascular

Cerebral vasoreactivity to arterial carbon dioxide tension in preterm infants: The effect of ibuprofen

1999 ◽  
Vol 135 (5) ◽  
pp. 644-646 ◽  
Author(s):  
Fabio Mosca ◽  
Milena Bray ◽  
Maria Rosa Colnaghi ◽  
Monica Fumagalli ◽  
Gilberto Compagnoni
Keyword(s):  
Carbon Dioxide ◽  
Preterm Infants ◽  
Carbon Dioxide Tension ◽  
Arterial Carbon Dioxide Tension ◽  
Arterial Carbon Dioxide ◽  
Cerebral Vasoreactivity

Metabolic and respiratory effects of flow-resistive loading in preterm infants

1991 ◽  
Vol 70 (2) ◽  
pp. 895-899 ◽  
Author(s):  
S. Duara ◽  
G. Silva Neto ◽  
T. Gerhardt ◽  
C. Suguihara ◽  
E. Bancalari
Keyword(s):  
Carbon Dioxide ◽  
Preterm Infants ◽  
Minute Ventilation ◽  
Carbon Dioxide Tension ◽  
Resistive Load ◽  
Intrinsic Resistance ◽  
Transcutaneous Oxygen ◽  
Resistive Loading ◽  
Before And After ◽  
Transcutaneous Carbon Dioxide Tension

Oxygen consumption (VO2) was measured during hypoventilation induced by moderate-sized flow-resistive loading in 12 preterm infants, and the results were compared with those obtained under basal conditions immediately before and after the loaded run, each of which lasted for 7-10 min. Loading was performed with a continuous flow-resistive load (inspiratory and expiratory), which was approximately threefold greater in magnitude than the intrinsic resistance of preterm infants. VO2, minute ventilation (VE), transcutaneous oxygen tension (PtCO2), and transcutaneous carbon dioxide tension (PtcCO2) were continuously monitored. Results revealed that VE decreased significantly with loading, from 336 +/- 103 to 231 +/- 58 (SD) ml.min-1.kg-1 (P less than 0.001), while returning to basal levels of 342 +/- 59 ml.min-1.kg-1 after discontinuation of the load. VO2 decreased from 7.2 +/- 1.2 to 5.9 +/- 0.9 ml.min-1.kg-1 with loading (P less than 0.001) and returned to 7.2 +/- 1.2 ml.min-1.kg-1 at the second basal measurement. PtcCO2 remained unchanged with loading, and PtcCO2 only increased from 39 +/- 8 to 41 +/- 9 Torr (P less than 0.05) with loading, while returning to 40 +/- 9 Torr at the second basal measurement. Results indicate a decrease in the metabolic rate and ventilation with loading, with relatively little increase in PtcCO2. These data can explain prior observations that minimal disturbances in oxygen and carbon dioxide tensions occur with hypoventilation during flow-resistive loading in neonates, although the precise mechanism for this reduction remains to be determined.

scholarly journals Carbon dioxide levels in neonates: what are safe parameters?

2021 ◽  
Author(s):  
Sie Kei Wong ◽  
M. Chim ◽  
J. Allen ◽  
A. Butler ◽  
J. Tyrrell ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Systematic Review ◽  
Side Effects ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
List Type ◽  
Permissive Hypercapnia ◽  
Prisma Statement ◽  
Carbon Dioxide Levels ◽  
Online Software

Abstract There is no consensus on the optimal pCO2 levels in the newborn. We reviewed the effects of hypercapnia and hypocapnia and existing carbon dioxide thresholds in neonates. A systematic review was conducted in accordance with the PRISMA statement and MOOSE guidelines. Two hundred and ninety-nine studies were screened and 37 studies included. Covidence online software was employed to streamline relevant articles. Hypocapnia was associated with predominantly neurological side effects while hypercapnia was linked with neurological, respiratory and gastrointestinal outcomes and Retinpathy of prematurity (ROP). Permissive hypercapnia did not decrease periventricular leukomalacia (PVL), ROP, hydrocephalus or air leaks. As safe pCO2 ranges were not explicitly concluded in the studies chosen, it was indirectly extrapolated with reference to pCO2 levels that were found to increase the risk of neonatal disease. Although PaCO2 ranges were reported from 2.6 to 8.7 kPa (19.5–64.3 mmHg) in both term and preterm infants, there are little data on the safety of these ranges. For permissive hypercapnia, parameters described for bronchopulmonary dysplasia (BPD; PaCO2 6.0–7.3 kPa: 45.0–54.8 mmHg) and congenital diaphragmatic hernia (CDH; PaCO2 ≤ 8.7 kPa: ≤65.3 mmHg) were identified. Contradictory findings on the effectiveness of permissive hypercapnia highlight the need for further data on appropriate CO2 parameters and correlation with outcomes. Impact There is no consensus on the optimal pCO2 levels in the newborn. There is no consensus on the effectiveness of permissive hypercapnia in neonates. A safe range of pCO2 of 5–7 kPa was inferred following systematic review.

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