The Incidence and Severity of Hypocarbia in Neonates Undergoing General Anesthesia.
BACKGROUND: Extended periods of hypocarbia in preterm infants may be associated with intraventricular hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia. To evaluate the current anesthetic practice in preterm neonates, we retrospectively reviewed the intraoperative course with...
| Publicado en: | Respiratory Care Vol. 65; no. 8; pp. 1154 - 1160 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Aug2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145118937&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145118937 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Aug2020 vid: 65 iid: 8 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 145118937 145118937 145118937 10.4187/respcare.07382 145118937 ppf: 1154 ppct: 6 formats: fmt: @attributes: type: P tig: atl: The Incidence and Severity of Hypocarbia in Neonates Undergoing General Anesthesia. aug: au: Chenault, Kristin Wakimoto, Mayuko Miller, Rebecca Tobias, Joseph D. affil: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio sug: subj: Hypocapnia Epidemiology Anesthesia, General Human Retrospective Design Hyperventilation Infant Infant, Premature Blood Gas Analysis Length of Stay Descriptive Statistics Infant, Newborn Confidence Intervals Infant: 1-23 months Infant, Newborn: birth-1 month ab: BACKGROUND: Extended periods of hypocarbia in preterm infants may be associated with intraventricular hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia. To evaluate the current anesthetic practice in preterm neonates, we retrospectively reviewed the intraoperative course with regard to PaCO2 and ventilation during non-cardiac surgical procedures in infants <60 weeks postmenstrual age. METHODS: This was a single-center, retrospective study during non-cardiac surgical procedures in neonates. Hyperventilation was defined as a PaCO2 ≤ 35 mm Hg, significant hyperventilation as a PaCO2 ≤ 30 mm Hg, and extreme hyperventilation as a PaCO2 ≤ 25 mm Hg. RESULTS: The study cohort included 112 neonates, with a median postnatal age of 40 weeks, median gestational age of 38 weeks, and median weight of 5 kg. Thirty-seven subjects (33%) had at least one arterial blood gas value that demonstrated hyperventilation. Thirteen (12%) were noted to have significant hyperventilation (PaCO2 ≤ 30 mm Hg) and 2 had extreme hyperventilation (PaCO2 ≤ 25 mm Hg). CONCLUSIONS: The incidence of at least one arterial blood gas that demonstrated inadvertent hyperventilation in neonates was high during intraoperative care. These data may provide the baseline for future studies that address more rigorous monitoring and control of PaCO2 during intraoperative care. Although the duration of the anesthetic care and surgical procedure is brief compared with the neonatal ICU length of stay because there is no demonstrated benefit of hypocapnia and, in fact, well-documented harm associated with hyperventilation in neonates, care should be directed at limiting inadvertent hyperventilation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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