Xiawei Ou1, Charles M. Glasier1, Raghu H. Ramakrishnaiah1, Sarah B. Mulkey2, Vivien L. Yap2, Jeffrey R. Kaiser2
1Radiology, Arkansas Children's Hospital; University of Arkansas for Medical Sciences, Little Rock, AR, United States; 2Pediatrics, Arkansas Children's Hospital; University of Arkansas for Medical Sciences, Little Rock, AR, United States
Permissive hypercapnia is a common ventilatory strategy used to avoid ventilator-induced lung injury. However, recent studies suggest that hypercapnia may be associated with increased risk of intraventricular hemorrhage (IVH) in extremely low birth-weight (ELBW) infants. In this study, we used a randomized controlled trial approach to assign ELBW infants to permissive hypercapnia ventilation or normocapnic ventilation during the first week of life, and compared the cranial ultrasound findings of IVH during the first week and MRI findings of blood products at term-equivalent age, to determine whether the occurrence of hemorrhage is different between the two groups. Our results suggest that ELBW infants with hypercapnic ventilation may be at higher risk of intracranial hemorrhage (ICH) in the brain.