{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:00:09Z","timestamp":1784653209788,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2018,4,3]],"date-time":"2018-04-03T00:00:00Z","timestamp":1522713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2018,8]]},"abstract":"\n BACKGROUND:<\/jats:title>\n \n Permissive hypercapnia is a lung-protection strategy. We sought to review our current clinical practice for the range of permissive hypercapnia and identify the relationship between P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n and pH and adverse outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n A secondary analysis of a delayed cord-clamping clinical trial was performed on all arterial blood gas tests in the first 72 h in infants < 32 weeks gestational age. All arterial blood gas values were categorized into a clinical range to determine the percent likelihood of occurring in the total sample. The univariate and multivariate relationships of severe adverse events and the time-weighted P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n , fluctuation of P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n , maximal and minimal P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n , base excess, and pH were assessed.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n 147 infants with birthweight of 1,206 \u00b1 395 g and gestational age of 28 \u00b1 2 weeks were included. Of the 1,316 total samples, < 2% had hypocapnia (P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n <30 mm Hg), 47% were normocapnic (P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n 35\u201345 mm Hg), 26.5% had mild hypercapnia (P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n 45\u201355 mm Hg), 13% had moderate hypercapnia (P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n 55\u201365 mm Hg), and 6.5% had severe hypercapnia (P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n \u2265 65 mm Hg). There were no adverse events associated with hypocapnia. Subjects with death\/severe intraventricular hemorrhage had a higher mean P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n of 52.3 versus 44.7 (odds ratio [OR] 1.16, 95% CI 1.04\u20131.29,\n P<\/jats:italic>\n = .006), higher variability of P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n with a standard deviation of 12.6 versus 7.8 (OR 1.15, 95% CI 1.03\u20131.27,\n P<\/jats:italic>\n = .01), and a lower minimum pH of 7.03 versus 7.23 (OR 0, 95% CI 0\u20130.06,\n P<\/jats:italic>\n = .003). There was no significant difference in any variables in subjects who developed other adverse events.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n \n The routine targeting of higher than normal P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n goals may lead to a low incidence of hypocapnia and associated adverse events. Hypercapnia is common, and moderate hypercapnia may increase the risk of neurologic injury and provide little pulmonary benefit.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.05801","type":"journal-article","created":{"date-parts":[[2018,4,3]],"date-time":"2018-04-03T11:35:47Z","timestamp":1522755347000},"page":"943-949","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["Incidence of Hypocapnia, Hypercapnia, and Acidosis and the Associated Risk of Adverse Events in Preterm Neonates"],"prefix":"10.1177","volume":"63","author":[{"given":"Melissa K","family":"Brown","sequence":"first","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah M","family":"Poeltler","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasim O","family":"Hassen","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle V","family":"Lazarus","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa K","family":"Brown","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah J","family":"Stout","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wade D","family":"Rich","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup C","family":"Katheria","sequence":"additional","affiliation":[{"name":"Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,4,3]]},"reference":[{"issue":"2","key":"e_1_3_3_2_2","first-page":"CD002061","article-title":"Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants","author":"Woodgate PG","year":"2001","unstructured":"Woodgate PG, , Davies MW. Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants. 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