Neonatal encephalopathy therapy optimization for better neuroprotection with inhalation of CO2: the HENRIC feasibility and safety trial.
Pediatr Res
; 87(6): 1025-1032, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-31785594
ABSTRACT
BACKGROUND:
There is an association between hypocapnia and adverse neurodevelopmental outcome in infants with neonatal encephalopathy (NE). Our aim was to test the safety and feasibility of 5% CO2 and 95% air inhalation to correct hypocapnia in mechanically ventilated infants with NE undergoing therapeutic hypothermia.METHODS:
Ten infants were assigned to this open-label, single-center trial. The gas mixture of 5% CO2 and 95% air was administered through patient circuits if the temperature-corrected PCO2 ≤40 mm Hg. The CO2 inhalation was continued for 12 h or was stopped earlier if the base deficit (BD) level decreased <5 mmol/L. Follow-up was performed using Bayley Scales of Infant Development II.RESULTS:
The patients spent a median 95.1% (range 44.6-98.5%) of time in the desired PCO2 range (40-60 mm Hg) during the inhalation. All PCO2 values were >40 mm Hg, the lower value of the target range. Regression modeling revealed that BD and lactate had a tendency to decrease during the intervention (by 0.61 and 0.55 mmol/L/h, respectively), whereas pH remained stable. The rate of moderate disabilities and normal outcome was 50%.CONCLUSIONS:
Our results suggest that inhaled 5% CO2 administration is a feasible and safe intervention for correcting hypocapnia.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Respiración Artificial
/
Encefalopatías
/
Dióxido de Carbono
/
Hipocapnia
/
Fármacos Neuroprotectores
/
Hipotermia Inducida
/
Enfermedades del Recién Nacido
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Humans
/
Newborn
País/Región como asunto:
Europa
Idioma:
En
Revista:
Pediatr Res
Año:
2020
Tipo del documento:
Article
País de afiliación:
Hungria