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Spontaneous hypocarbia without mechanical ventilation in preterm infants with cystic periventricular leukomalacia
Author(s) -
Stenzel Melanie,
StüweKunz Laura,
Bührer Christoph,
Roll Claudia
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15235
Subject(s) - medicine , mechanical ventilation , periventricular leukomalacia , anesthesia , ventilation (architecture) , gestational age , respiratory system , respiratory acidosis , acidosis , pregnancy , mechanical engineering , biology , engineering , genetics
Abstract Aim Hypocarbia induced by mechanical ventilation has been considered a main cause of cystic periventricular leukomalacia (cPVL). However, hypocarbia may occur spontaneously in response to intracellular metabolic acidosis. We aimed to assess whether hypocarbia is more common during mechanical respiratory support than during spontaneous ventilation in infants with cPVL. Method In this single‐centre, retrospective chart analysis, we compared partial pressure of carbon dioxide (pCO 2 ) during the first 96 hours of life in infants with cPVL during endotracheal mechanical ventilation, non‐invasive respiratory support, or without respiratory support. Results Cystic periventricular leukomalacia was diagnosed in 23 infants born between 2006 and 2017. Gestational age was 24 weeks in two infants and ranged between 28 and 32 weeks in 21 infants. In these 21 infants, pCO 2 less than 35 mm Hg during the first 96 ours of life accounted for 9/60 (15%) measurements during endotracheal mechanical ventilation, 16/116 (14%) during non‐invasive respiratory support and 14/42 (33%) in infants without respiratory support ( P = .014). Conclusion In our series of infants with cPVL, hypocarbia was more common without respiratory support than during endotracheal mechanical ventilation and non‐invasive respiratory support. This would suggest that hypocarbia is a symptom rather than a cause of cPVL in these infants.