Psychological evaluation in children who had had arterial oxygen partial pressures of less than 63 Torr

The purpose of this study was to examine the incidence and type of neurological sequelae in patients surviving after a severe acute episode of hypoxemia. We defined hypoxemia as Pa,O 2 below 63 Ton. Twenty five patients, newborn to 11 years of age, who survived hypoxemia and respiratory or cardiac arrest, were included: three with Pa,O 2 ranging from 40 to 49 Torr, two from 30 to 39 Torr and twenty with Pa,O 2 below 30 Torr. In five of them respiratory arrest occurred, and in two cases, the heart stopped twice. The psychological tests were chosen according to the patient's age. The incidence of sequelae was 64% as follows; motor area, 28%; I.Q. below 90, 20 %; left hand dominance, 16%; language disabilities, 12%; disturbances of perception, 4%; and various other different minor findings, 12%. The frequency of sequelae according to the age was as follows: among children who were less than two years old 53% had sequelae; from 2 to 5 years, 66%; and older than five years, 83%. The lowest I.Q. was found in a patient with hypoxemia grade 2; children with hypoxemia grade 4 did not have the lowest I.Q., 80% of them had I.Q.s of 90. It was concluded that hypoxemia is a potential factor in the development of brain damage, and that it has many behavioral or functional expressions. It seems to be more dangerous for older children. Patients having grade 4 hypoxia had a normal distribution of I.Q., so that one can conclude that this type of illness does not necesarily interfere with intellectual capacity. We believe that these results could be improved if the patient is treated by modern methods of cerebral resuscitation.