{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:03Z","timestamp":1791489663145,"version":"4.3.4"},"reference-count":26,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2017,1,9]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Elevated carbon dioxide (CO<jats:sub>2<\/jats:sub>) blood levels have a depressant effect on the central nervous system and can lead to coma in adults. Less is known about the effect of CO<jats:sub>2<\/jats:sub> on the neurological function of infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe the effect of acute severe hypercapnia (PaCO<jats:sub>2<\/jats:sub> &gt;70\u2005mm\u2005Hg) on amplitude-integrated electroencephalography (aEEG) and cerebral oxygenation in newborn infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>Observational study of full-term and preterm infants with acute severe hypercapnia (identified by arterial blood gas measurements), monitored with aEEG. Visual analysis of the aEEG was performed in all infants. In preterm infants &lt;32\u2005weeks postmenstrual age (PMA), analysis of two-channel EEG was performed. Mean spontaneous activity transients (SAT) rate (SATs\/min), interval between SATs (ISI in seconds) and the ISI percentage (ISP) were calculated for 10-min periods before, during and after hypercapnia. Mean regional cerebral oxygen saturation (rScO<jats:sub>2<\/jats:sub>) and fractional tissue oxygen extraction (FTOE) measured with near-infrared spectroscopy were also calculated for these periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-five infants (21 preterm, 4 full-term) comprising 32 episodes of acute severe hypercapnia were identified. Twenty-seven episodes were accompanied by a transient aEEG depression. Twenty-two episodes in 15 preterm infants &lt;32\u2005weeks PMA were quantitatively analysed. During hypercapnia, SAT rate decreased and ISI and ISP increased significantly. No significant change occurred in rScO<jats:sub>2<\/jats:sub> or FTOE during hypercapnia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Profound depression of brain activity due to severe hypercapnia is also seen in infants. It can be recognised by an acute depression of the aEEG, without clinically detectable changes in cerebral oxygenation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2016-311770","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T21:50:22Z","timestamp":1485553822000},"page":"F383-F388","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Severe hypercapnia causes reversible depression of aEEG background activity in neonates: an observational study"],"prefix":"10.1136","volume":"102","author":[{"given":"Lauren C","family":"Weeke","sequence":"first","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M L","family":"Dix","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris","family":"Groenendaal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra M A","family":"Lemmers","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen P","family":"Dijkman","sequence":"additional","affiliation":[{"name":"Department of Neonatology, M\u00e1xima Medical Centre, Veldhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Andriessen","sequence":"additional","affiliation":[{"name":"Department of Neonatology, M\u00e1xima Medical Centre, Veldhoven, The Netherlands"},{"name":"Department of Pediatrics, Faculty of Health, Medicine and Life Science, University of Maastricht, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda S","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona C","family":"Toet","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,1,27]]},"reference":[{"key":"2025090512575462000_102.5.F383.1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/0887-8994(96)00116-6","article-title":"Seizure susceptibility during recovery from hypercapnia in neonatal dogs","volume":"15","author":"Yoshioka","year":"1996","journal-title":"Pediatr Neurol"},{"key":"2025090512575462000_102.5.F383.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2008.10.020"},{"key":"2025090512575462000_102.5.F383.3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/00005792-195612000-00003","article-title":"Carbon dioxide intoxication: the clinical syndrome, its etiology and management with particular reference to the use of mechanical respirators","volume":"35","author":"Sieker","year":"1956","journal-title":"Medicine (Baltimore)"},{"key":"2025090512575462000_102.5.F383.4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2755"},{"key":"2025090512575462000_102.5.F383.5","doi-asserted-by":"publisher","DOI":"10.1203\/01.pdr.0000169402.13435.09"},{"key":"2025090512575462000_102.5.F383.6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.5.772"},{"key":"2025090512575462000_102.5.F383.7","doi-asserted-by":"publisher","DOI":"10.1088\/0967-3334\/31\/11\/N02"},{"key":"2025090512575462000_102.5.F383.8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.102.4.1298"},{"key":"2025090512575462000_102.5.F383.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2008.02.012"},{"key":"2025090512575462000_102.5.F383.10","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200010000-00026"},{"key":"2025090512575462000_102.5.F383.11","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1982.56.4.0482"},{"key":"2025090512575462000_102.5.F383.12","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.8.3.358"},{"key":"2025090512575462000_102.5.F383.13","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/j.1651-2227.1994.tb13064.x","article-title":"Reversible changes in cerebral activity associated with acidosis in preterm neonates","volume":"83","author":"Eaton","year":"1994","journal-title":"Acta Paediatr"},{"key":"2025090512575462000_102.5.F383.14","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.100800"},{"key":"2025090512575462000_102.5.F383.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2012.03.018"},{"key":"2025090512575462000_102.5.F383.16","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198701000-00008"},{"key":"2025090512575462000_102.5.F383.17","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(03)00336-5"},{"key":"2025090512575462000_102.5.F383.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(99)00022-5"},{"key":"2025090512575462000_102.5.F383.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2008.08.005"},{"key":"2025090512575462000_102.5.F383.20","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(00)00433-8"},{"key":"2025090512575462000_102.5.F383.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.02.024"},{"key":"2025090512575462000_102.5.F383.22","doi-asserted-by":"publisher","DOI":"10.1203\/01.pdr.0000182180.80645.0c"},{"key":"2025090512575462000_102.5.F383.23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/S0140-6736(86)92166-5","article-title":"May hypocarbia cause ischaemic brain damage in the preterm infant?","volume":"2","author":"Greisen","year":"1986","journal-title":"Lancet"},{"key":"2025090512575462000_102.5.F383.24","doi-asserted-by":"publisher","DOI":"10.1159\/000345923"},{"key":"2025090512575462000_102.5.F383.25","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1203\/PDR.0b013e3181d4ecda","article-title":"Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation","volume":"67","author":"Bowen","year":"2010","journal-title":"Pediatr Res"},{"key":"2025090512575462000_102.5.F383.26","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1038\/pr.2014.71","article-title":"Effect of permissive hypercapnia on background cerebral electrical activity in premature babies","volume":"76","author":"Victor","year":"2014","journal-title":"Pediatr Res"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2016-311770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:58:05Z","timestamp":1757102285000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/archdischild-2016-311770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,27]]},"references-count":26,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2017,8,18]]},"published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1136\/archdischild-2016-311770"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2016-311770","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,27]]}}}