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Original Article
J Korean Soc Neonatol.. 2002;9(2):150-158. Published online November 1, 2002.
The Relation between Hypocarbia and Periventricular Leukomalacia in Preterm Infants with Mechanical Ventilation.
Eun Hye Park, Ran Namgung, Min Soo Park, Kook In Park, Myung Joon Kim, Chul Lee
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. ranng@yumc.yonsei.ac.kr
2Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
PURPOSE
To investigate whether hypocarbia during the first 3 days of life plays a role in the development of periventricular leukomalacia (PVL) in preterm infants with mechanical ventilation.
METHODS
The medical records were reviewed for 19 infants with PVL and 38 with normal neurosonogram who were born before 37 weeks' gestation and who required mechanical ventilation during the first 3 days of life. The patients' characteristics, antenatal and neonatal variables were compared. The CO2 index, TA (time-averaged)-PaCO2, TA-PaO2 and TA-pH were calculated within the first 72 hours of life. The TA-FiO2, TA-respiratory rate (RR), TA-peak inspiratory pressure (PIP), TA-mean airway pressure (MAP) and TA-ventilator index (VI) were also calculated.
RESULTS
No significant difference was observed in the clinical characteristics or neonatal variables except hyaline membrane disease (42% in PVL group vs 81% in control group)(P=0.0025). There were no significant differences in CO2 index, TA-PaCO2 and TA- PaO2 between groups. The TA-pH was lower in infants with PVL (7.33+/-0.06) than in control group (7.37+/-0.05) (P=0.035). The TA-FiO2, TA-RR, TA-PIP, TA-MAP and TA- VI of two groups showed no significant differences.
CONCLUSION
Partial pressure of arterial carbon dioxide during the first 3 days of life was not associated with the subsequent development of PVL. The compound effects of other risk factors including systemic pH may be important in the development of PVL in preterm infants.

Keywords :Periventricular leukomalacia;Hypocarbia;Mechanical ventilation

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