Transcutaneous carbon dioxide pattern and trend over time in preterm infants
Background Chronic lung disease remains a burden for extremely preterm infants. The changes in ventilation over time and optimal ventilatory management remains unknown. Newer, non-invasive technologies provide insight into these patterns. Methods This single-center prospective cohort study enrolled...
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| Veröffentlicht in: | Pediatric research 2021-10, Vol.90 (4), p.840-846 |
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| creator | Sullivan, Katherine P. White, Heather O. Grover, Lindsay E. Negron, Jordi J. Lee, Austin F. Rhein, Lawrence M. |
| description | Background
Chronic lung disease remains a burden for extremely preterm infants. The changes in ventilation over time and optimal ventilatory management remains unknown. Newer, non-invasive technologies provide insight into these patterns.
Methods
This single-center prospective cohort study enrolled infants ≤32 0/7 weeks. We obtained epochs of transcutaneous carbon dioxide (TcCO
2
) measurements twice each week to describe the pattern of hypercarbia throughout their hospitalization.
Results
Patterns of hypercarbia varied based on birth gestational age and post-menstrual age (PMA) (
p
= 0.03), regardless of respiratory support. Infants receiving the most respiratory support had values 16–21 mmHg higher than those on room air (
p
|
| doi_str_mv | 10.1038/s41390-020-01308-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7814526</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2479419631</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-adc7bea8ad1a63d02be068d6c86e60e2386e61af1dc7c14a9d29d8d355dc46263</originalsourceid><addsrcrecordid>eNp9UU1vGyEQRVWr2vn4AzlUK_WSyyZ8LQuXSpXVfEiWcnHPiIVxupEXXGCt9N-HZF2nzSEHmEHvzWNmHkJnBF8QzORl4oQpXGNaDmFY1vQDmpOGlSfn7Uc0x5iRmiklZ-gopQeMCW8k_4xmjHGhiJRztFxF45Mds_EQxlRZE7vgK9eHx95BtTU5Q_SV8a7KEcoddhCr3A9Q9b7aRijwUNK18TmdoE9rs0lwuo_H6OfVj9Xipl7eXd8uvi9ry1uea-Ns24GRxhEjmMO0AyykE1YKEBgoe47ErEnhWcKNclQ56VjTOMsFFewYfZt0t2M3gLPgczQbvY39YOIfHUyv_0d8_0vfh51uZdnAi8D5XiCG3yOkrIc-Wdhspi1oylvFiRKMFOrXN9SHMEZfxtO0UbQV-47oxLIxpBRhfWiGYP1slp7M0sUs_WKWpqXoy79jHEr-ulMIbCKkAvl7iK9_vyP7BDdvoTg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2592764626</pqid></control><display><type>article</type><title>Transcutaneous carbon dioxide pattern and trend over time in preterm infants</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sullivan, Katherine P. ; White, Heather O. ; Grover, Lindsay E. ; Negron, Jordi J. ; Lee, Austin F. ; Rhein, Lawrence M.</creator><creatorcontrib>Sullivan, Katherine P. ; White, Heather O. ; Grover, Lindsay E. ; Negron, Jordi J. ; Lee, Austin F. ; Rhein, Lawrence M.</creatorcontrib><description>Background
Chronic lung disease remains a burden for extremely preterm infants. The changes in ventilation over time and optimal ventilatory management remains unknown. Newer, non-invasive technologies provide insight into these patterns.
Methods
This single-center prospective cohort study enrolled infants ≤32 0/7 weeks. We obtained epochs of transcutaneous carbon dioxide (TcCO
2
) measurements twice each week to describe the pattern of hypercarbia throughout their hospitalization.
Results
Patterns of hypercarbia varied based on birth gestational age and post-menstrual age (PMA) (
p
= 0.03), regardless of respiratory support. Infants receiving the most respiratory support had values 16–21 mmHg higher than those on room air (
p
< 0.001). Infants born at the youngest gestational ages had the greatest total change but the rate of change was slower (
p
= 0.049) compared to infants born at later gestational ages. All infants had TcCO
2
values stabilize by 31–33 weeks PMA, when values were not significantly different compared to discharge. No rebound was observed when infants weaned off invasive support.
Conclusions
Hypercarbia improves as infants approached 31–33 weeks PMA. Hypercarbia was the highest in the most immature infants and improved with age and growth despite weaning respiratory support.
Impact
This study describes the evolution of hypercarbia as very preterm infants grow and develop.
The pattern of ventilation is significantly different depending on the gestational age at birth and post-menstrual age.
Average transcutaneous carbon dioxide (TCO
2
) decreased over time as infants became more mature despite weaning respiratory support. This improvement was most significant in infants born at the lowest gestational ages.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-020-01308-2</identifier><identifier>PMID: 33469188</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Blood Gas Monitoring, Transcutaneous - methods ; Carbon dioxide ; Carbon Dioxide - analysis ; Clinical ; Clinical Research Article ; Female ; Gestational age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Medicine ; Medicine & Public Health ; Menstruation ; Newborn babies ; Pediatric Surgery ; Pediatrics ; Premature babies ; Prospective Studies ; Weaning</subject><ispartof>Pediatric research, 2021-10, Vol.90 (4), p.840-846</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2020</rights><rights>2020. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-adc7bea8ad1a63d02be068d6c86e60e2386e61af1dc7c14a9d29d8d355dc46263</citedby><cites>FETCH-LOGICAL-c474t-adc7bea8ad1a63d02be068d6c86e60e2386e61af1dc7c14a9d29d8d355dc46263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-020-01308-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-020-01308-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33469188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sullivan, Katherine P.</creatorcontrib><creatorcontrib>White, Heather O.</creatorcontrib><creatorcontrib>Grover, Lindsay E.</creatorcontrib><creatorcontrib>Negron, Jordi J.</creatorcontrib><creatorcontrib>Lee, Austin F.</creatorcontrib><creatorcontrib>Rhein, Lawrence M.</creatorcontrib><title>Transcutaneous carbon dioxide pattern and trend over time in preterm infants</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background
Chronic lung disease remains a burden for extremely preterm infants. The changes in ventilation over time and optimal ventilatory management remains unknown. Newer, non-invasive technologies provide insight into these patterns.
Methods
This single-center prospective cohort study enrolled infants ≤32 0/7 weeks. We obtained epochs of transcutaneous carbon dioxide (TcCO
2
) measurements twice each week to describe the pattern of hypercarbia throughout their hospitalization.
Results
Patterns of hypercarbia varied based on birth gestational age and post-menstrual age (PMA) (
p
= 0.03), regardless of respiratory support. Infants receiving the most respiratory support had values 16–21 mmHg higher than those on room air (
p
< 0.001). Infants born at the youngest gestational ages had the greatest total change but the rate of change was slower (
p
= 0.049) compared to infants born at later gestational ages. All infants had TcCO
2
values stabilize by 31–33 weeks PMA, when values were not significantly different compared to discharge. No rebound was observed when infants weaned off invasive support.
Conclusions
Hypercarbia improves as infants approached 31–33 weeks PMA. Hypercarbia was the highest in the most immature infants and improved with age and growth despite weaning respiratory support.
Impact
This study describes the evolution of hypercarbia as very preterm infants grow and develop.
The pattern of ventilation is significantly different depending on the gestational age at birth and post-menstrual age.
Average transcutaneous carbon dioxide (TCO
2
) decreased over time as infants became more mature despite weaning respiratory support. This improvement was most significant in infants born at the lowest gestational ages.</description><subject>Blood Gas Monitoring, Transcutaneous - methods</subject><subject>Carbon dioxide</subject><subject>Carbon Dioxide - analysis</subject><subject>Clinical</subject><subject>Clinical Research Article</subject><subject>Female</subject><subject>Gestational age</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Menstruation</subject><subject>Newborn babies</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Premature babies</subject><subject>Prospective Studies</subject><subject>Weaning</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9UU1vGyEQRVWr2vn4AzlUK_WSyyZ8LQuXSpXVfEiWcnHPiIVxupEXXGCt9N-HZF2nzSEHmEHvzWNmHkJnBF8QzORl4oQpXGNaDmFY1vQDmpOGlSfn7Uc0x5iRmiklZ-gopQeMCW8k_4xmjHGhiJRztFxF45Mds_EQxlRZE7vgK9eHx95BtTU5Q_SV8a7KEcoddhCr3A9Q9b7aRijwUNK18TmdoE9rs0lwuo_H6OfVj9Xipl7eXd8uvi9ry1uea-Ns24GRxhEjmMO0AyykE1YKEBgoe47ErEnhWcKNclQ56VjTOMsFFewYfZt0t2M3gLPgczQbvY39YOIfHUyv_0d8_0vfh51uZdnAi8D5XiCG3yOkrIc-Wdhspi1oylvFiRKMFOrXN9SHMEZfxtO0UbQV-47oxLIxpBRhfWiGYP1slp7M0sUs_WKWpqXoy79jHEr-ulMIbCKkAvl7iK9_vyP7BDdvoTg</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Sullivan, Katherine P.</creator><creator>White, Heather O.</creator><creator>Grover, Lindsay E.</creator><creator>Negron, Jordi J.</creator><creator>Lee, Austin F.</creator><creator>Rhein, Lawrence M.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211001</creationdate><title>Transcutaneous carbon dioxide pattern and trend over time in preterm infants</title><author>Sullivan, Katherine P. ; White, Heather O. ; Grover, Lindsay E. ; Negron, Jordi J. ; Lee, Austin F. ; Rhein, Lawrence M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-adc7bea8ad1a63d02be068d6c86e60e2386e61af1dc7c14a9d29d8d355dc46263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood Gas Monitoring, Transcutaneous - methods</topic><topic>Carbon dioxide</topic><topic>Carbon Dioxide - analysis</topic><topic>Clinical</topic><topic>Clinical Research Article</topic><topic>Female</topic><topic>Gestational age</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Menstruation</topic><topic>Newborn babies</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Premature babies</topic><topic>Prospective Studies</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sullivan, Katherine P.</creatorcontrib><creatorcontrib>White, Heather O.</creatorcontrib><creatorcontrib>Grover, Lindsay E.</creatorcontrib><creatorcontrib>Negron, Jordi J.</creatorcontrib><creatorcontrib>Lee, Austin F.</creatorcontrib><creatorcontrib>Rhein, Lawrence M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sullivan, Katherine P.</au><au>White, Heather O.</au><au>Grover, Lindsay E.</au><au>Negron, Jordi J.</au><au>Lee, Austin F.</au><au>Rhein, Lawrence M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcutaneous carbon dioxide pattern and trend over time in preterm infants</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>90</volume><issue>4</issue><spage>840</spage><epage>846</epage><pages>840-846</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
Chronic lung disease remains a burden for extremely preterm infants. The changes in ventilation over time and optimal ventilatory management remains unknown. Newer, non-invasive technologies provide insight into these patterns.
Methods
This single-center prospective cohort study enrolled infants ≤32 0/7 weeks. We obtained epochs of transcutaneous carbon dioxide (TcCO
2
) measurements twice each week to describe the pattern of hypercarbia throughout their hospitalization.
Results
Patterns of hypercarbia varied based on birth gestational age and post-menstrual age (PMA) (
p
= 0.03), regardless of respiratory support. Infants receiving the most respiratory support had values 16–21 mmHg higher than those on room air (
p
< 0.001). Infants born at the youngest gestational ages had the greatest total change but the rate of change was slower (
p
= 0.049) compared to infants born at later gestational ages. All infants had TcCO
2
values stabilize by 31–33 weeks PMA, when values were not significantly different compared to discharge. No rebound was observed when infants weaned off invasive support.
Conclusions
Hypercarbia improves as infants approached 31–33 weeks PMA. Hypercarbia was the highest in the most immature infants and improved with age and growth despite weaning respiratory support.
Impact
This study describes the evolution of hypercarbia as very preterm infants grow and develop.
The pattern of ventilation is significantly different depending on the gestational age at birth and post-menstrual age.
Average transcutaneous carbon dioxide (TCO
2
) decreased over time as infants became more mature despite weaning respiratory support. This improvement was most significant in infants born at the lowest gestational ages.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>33469188</pmid><doi>10.1038/s41390-020-01308-2</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2021-10, Vol.90 (4), p.840-846 |
| issn | 0031-3998 1530-0447 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7814526 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
| subjects | Blood Gas Monitoring, Transcutaneous - methods Carbon dioxide Carbon Dioxide - analysis Clinical Clinical Research Article Female Gestational age Humans Infant, Newborn Infant, Premature Male Medicine Medicine & Public Health Menstruation Newborn babies Pediatric Surgery Pediatrics Premature babies Prospective Studies Weaning |
| title | Transcutaneous carbon dioxide pattern and trend over time in preterm infants |
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