Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Jun 17;5(1):764.
doi: 10.1186/s40064-016-2437-5. eCollection 2016.

Effects of permissive hypercapnia on pulmonary and neurodevelopmental sequelae in extremely low birth weight infants: a meta-analysis

Jianglin Ma  1 , Hui Ye  2
Affiliations
Review

Effects of permissive hypercapnia on pulmonary and neurodevelopmental sequelae in extremely low birth weight infants: a meta-analysis

Jianglin Ma et al. Springerplus. .

Abstract

Objectives: To perform a systematic review and meta-analysis of the efficacy and safety of permissive hypercapnia in extremely low birth weight infants.

Methods: A systematic search of MEDLINE, EMBASE, the Cochrane Database of randomized trials. Eligibility and quality of trials were assessed, and data on study design, patient characteristics, and relevant outcomes were extracted.

Results: Four studies that enrolled a total of 693 participants were selected. Meta-analysis revealed no effect of permissive hypercapnia on decreasing rates of bronchopulmonary dysplasia (BPD). Permissive hypercapnia also had no significant effect on mortality, intraventricular haemorrhage (IVH), IVH (grade 3-4), periventricular leukomalacia (PVL), necrotising enterocolitis (NEC), retinopathy of prematurity (ROP) or air leaks in extremely low birth weight infants. Neurodevelopmental outcomes were comparable at 18-22 months' corrected age in two studies. permissive hypercapnia did not increase the risk of cerebral palsy, Mental Developmental Index <70, Psychomotor Developmental Index <70, visual deficit, or hearing deficit.

Conclusions: Permissive hypercapnia did not reduce the rate of BPD in extremely low birth weight infants. The rates of mortality, IVH, PVL, NEC, ROP and neurodevelopmental outcomes did not differ between these two groups. These results suggest that permissive hypercapnia does not bring extra benefits in extremely low birth weight infants.

Keywords: Extremely low birth weight infants; Lung protection; Meta-analysis; Neurodevelopmental sequelae; Permissive hypercapnia.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Forest plot of the BPD in extremely low birth weight infants who received permissive hypercapnia to controls. CI confidence interval, df degrees of freedom, PHC permissive hypercapnia, M–H Mantel–Haenszel
Fig. 2
Fig. 2
Overall results showing odds ratios and 95 % confidence intervals, calculated according to either fixed or random effects models, for the analysed other effectiveness parameters. Other effectiveness outcomes in extremely low birth weight infants who received permissive hypercapnia compared to controls. IVH intraventricular haemorrhag, PVL periventricular leukomalacia, NEC necrotising enterocolitis, ROP retinopathy of prematurity
Fig. 3
Fig. 3
Overall results showing odds ratios and 95 % confidence intervals, calculated according to either fixed or random effects models, for the analysed neurodevelopmental Sequelae parameters. Neurodevelopmental Sequelae in extremely low birth weight infants who received permissive hypercapnia compared to controls. MDI Mental Developmental Index, PDI Psychomotor Developmental Index
See this image and copyright information in PMC

References

    1. Ambalavanan N, Carlo WA. Hypocapnia and hypercapnia in respiratory management of newborn infants. Clin Perinatol. 2001;28(3):517–531. doi: 10.1016/S0095-5108(05)70104-4. - DOI - PubMed
    1. Avery ME, Tooley WH, Keller JB, Hurd SS, Bryan MH, Cotton RB, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics. 1987;79(1):26–30. - PubMed
    1. Carlo WA, Stark AR, Wright LL, Tyson JE, Papile LA, Shankaran S, et al. Minimal ventilation to prevent bronchopulmonary dysplasia in extremely-low-birth-weight infants. J Pediatr. 2002;141(3):370–374. doi: 10.1067/mpd.2002.127507. - DOI - PubMed
    1. Doyle LW, Faber B, Callanan C. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics. 2006;118(1):108–113. doi: 10.1542/peds.2005-2522. - DOI - PubMed
    1. Dunn MS, Kaempf J, de Klerk A, de Klerk R, Reilly M, Howard D, et al. Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics. 2011;128(5):e1069. doi: 10.1542/peds.2010-3848. - DOI - PubMed

LinkOut - more resources