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Our aim was to determine whether carbon dioxide (CO<jats:sub>2<\/jats:sub>) levels in the first 3 days after birth reflected abnormal EtCO<jats:sub>2<\/jats:sub> levels in the delivery suite, and hence, a prolonged rather than an early insult resulted in IVH. In addition, we determined if greater EtCO<jats:sub>2<\/jats:sub>level fluctuations during resuscitation occurred in infants who developed IVH. EtCO<jats:sub>2<\/jats:sub> levels during delivery suite resuscitation and CO<jats:sub>2<\/jats:sub> levels on the neonatal unit were evaluated in 58 infants (median gestational age 27.3 weeks). Delta EtCO<jats:sub>2<\/jats:sub> was the difference between the highest and lowest level of EtCO<jats:sub>2<\/jats:sub>. Thirteen infants developed a grade 3\u20134 IVH (severe group). There were no significant differences in CO<jats:sub>2<\/jats:sub> levels between those who did and did not develop an IVH (or severe IVH) on the NICU. The delta EtCO<jats:sub>2<\/jats:sub> during resuscitation differed between infants with any IVH (6.2 (5.4\u20137.5) kPa) or no IVH (3.8 (2.7\u20134.3) kPA) (<jats:italic>p<\/jats:italic> &lt; 0.001) after adjusting for differences in gestational age. Delta EtCO<jats:sub>2<\/jats:sub> levels gave an area under the ROC curve of 0.940 for prediction of IVH.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: The results emphasize the importance of monitoring EtCO<jats:sub>2<\/jats:sub> levels in the delivery suite.<jats:table-wrap><jats:table><jats:tbody>\n<jats:tr>\n<jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold>\u2022 <jats:italic>Abnormal levels of carbon dioxide (CO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>) in the first few days after birth and abnormal end-tidal CO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>levels (EtCO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>) levels during resuscitation are associated in preterm infants with the risk of developing intraventricular haemorrhage (IVH).<\/jats:italic><\/jats:td>\n<\/jats:tr>\n<jats:tr>\n<jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold>\u2022 <jats:italic>There were no significant differences in NICU CO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>levels between those who developed an IVH or no IVH.<\/jats:italic>\u2022 <jats:italic>There was a poor correlation between delivery suite ETCO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>levels and NICU CO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>levels.<\/jats:italic>\u2022 <jats:italic>Large fluctuations in EtCO<\/jats:italic><jats:sub><jats:italic>2<\/jats:italic><\/jats:sub><jats:italic>during resuscitation in the delivery suite were highly predictive of IVH development in preterm infants.<\/jats:italic><\/jats:td>\n<\/jats:tr>\n<\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-019-03543-0","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T18:02:51Z","timestamp":1576605771000},"page":"555-559","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["End-tidal carbon dioxide levels during resuscitation and carbon dioxide levels in the immediate neonatal period and intraventricular haemorrhage"],"prefix":"10.1007","volume":"179","author":[{"given":"Kentaro","family":"Tamura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma E","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore","family":"Dassios","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoop","family":"Pahuja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie A","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadivelam","family":"Murthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashanth","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravindra","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Milner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8672-5349","authenticated-orcid":false,"given":"Anne","family":"Greenough","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,12,17]]},"reference":[{"key":"3543_CR1","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1046\/j.1440-1754.2002.00041.x","volume":"38","author":"SJ Erickson","year":"2002","unstructured":"Erickson SJ, Grauaug A, Gurrin L, Swaminathan M (2002) Hypocarbia in the ventilated preterm infant and its effect on intraventricular haemorrhage and bronchopulmonary dysplasia. 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