{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:44:47Z","timestamp":1791398687466,"version":"4.3.3"},"reference-count":32,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["Th626\/5-1"],"award-info":[{"award-number":["Th626\/5-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2016,12,9]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tolerating higher partial pressures of carbon dioxide (PCO<jats:sub>2<\/jats:sub>) in mechanically ventilated extremely low birthweight infants to reduce ventilator-induced lung injury may have long-term neurodevelopmental side effects. This study analyses the results of neurodevelopmental follow-up of infants enrolled in a randomised multicentre trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Infants (n=359) between 400 and 1000\u2005g birth weight and 23 0\/7\u201328 6\/7\u2005weeks gestational age who required endotracheal intubation and mechanical ventilation within 24\u2005hours of birth were randomly assigned to high PCO<jats:sub>2<\/jats:sub> or to a control group with mildly elevated PCO<jats:sub>2<\/jats:sub> targets. Neurodevelopmental follow-up examinations were available for 85% of enrolled infants using the Bayley Scales of Infant Development II, the Gross Motor Function Classification System (GMFCS) and the Child Development Inventory (CDI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were no differences in body weight, length and head circumference between the two PCO<jats:sub>2<\/jats:sub> target groups. Median Mental Developmental Index (MDI) values were 82 (60\u201396, high target) and 84 (58\u201396, p=0.79). Psychomotor Developmental Index (PDI) values were 84 (57\u2013100) and 84 (65\u201396, p=0.73), respectively. Moreover, there was no difference in the number of infants with MDI or PDI &lt;70 or &lt;85 and the number of infants with a combined outcome of death or MDI&lt;70 and death or PDI&lt;70. No differences were found between results for GMFCS and CDI. The risk factors for MDI&lt;70 or PDI&lt;70 were intracranial haemorrhage, bronchopulmonary dysplasia, periventricular leukomalacia, necrotising enterocolitis and hydrocortisone treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A higher PCO<jats:sub>2<\/jats:sub> target did not influence neurodevelopmental outcomes in mechanically ventilated extremely preterm infants. Adjusting PCO<jats:sub>2<\/jats:sub> targets to optimise short-term outcomes is a safe option.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ISRCTN56143743.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2016-311581","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T21:50:43Z","timestamp":1484344243000},"page":"F376-F382","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Neurodevelopmental outcomes of extremely low birthweight infants randomised to different PCO<sub>2<\/sub> targets: the PHELBI follow-up study"],"prefix":"10.1136","volume":"102","clinical-trial-number":[{"clinical-trial-number":"isrctn56143743","registry":"10.18810\/isrctn"}],"author":[{"given":"Ulrich H","family":"Thome","sequence":"first","affiliation":[{"name":"Division of Neonatology, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya","family":"Genzel-Boroviczeny","sequence":"additional","affiliation":[{"name":"Division of Neonatology, IS Dr. von Hauner University Children's Hospital, Ludwig Maximilian University of Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Bohnhorst","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Schmid","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, University of Ulm, Ulm, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Albert Ludwigs University Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Rohde","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pediatric Critical Care, Elisabeth Children's Hospital, Klinikum Oldenburg, Medical Campus, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Avenarius","sequence":"additional","affiliation":[{"name":"Hospital for General Pediatrics and Neonatology, Otto von Guericke University Magdeburg, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Georg","family":"Topf","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University Hospital for Children and Adolescents, Friedrich-Alexander University Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Mutter-Kind-Zentrum, Klinikum rechts der Isar, Technical University of Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Faas","sequence":"additional","affiliation":[{"name":"University Hospital for General Pediatrics and Neonatology, Justus Liebig University Giessen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Timme","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Hospital for Children and Adolescents, Vivantes-Hospital Neuk\u00f6lln, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kleinlein","sequence":"additional","affiliation":[{"name":"Hospital for Children and Adolescents, Children's Hospital of the Third Order, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Buxmann","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University Hospital for Children and Adolescents of the J.W. Goethe University Frankfurt\/Main, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Schenk","sequence":"additional","affiliation":[{"name":"Hospital for Children and Adolescents, Central Hospital Augsburg, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Segerer","sequence":"additional","affiliation":[{"name":"St. Hedwig Hospital, University of Regensburg (H.S.), Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Teig","sequence":"additional","affiliation":[{"name":"Department of Neonatology and Pediatric Intensive Care, Katholisches Klinikum, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annett","family":"Bl\u00e4ser","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Hentschel","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Albert Ludwigs University Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Heckmann","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Ernst Moritz Arndt University Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Schl\u00f6sser","sequence":"additional","affiliation":[{"name":"Division of Neonatology, University Hospital for Children and Adolescents of the J.W. 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