Hypocapnia in early hours of life is associated with brain injury in moderate to severe neonatal encephalopathy

Objective To evaluate the association between hypocapnia within the first 24 h of life and brain injury assessed by a detailed MRI scoring system in infants receiving therapeutic hypothermia (TH) for neonatal encephalopathy (NE) stratified by the stage of NE. Study design This retrospective cohort study included infants who received TH for mild to severe NE. Results 188 infants were included in the study with 48% having mild and 52% moderate-severe NE. Infants with moderate-severe NE spent more time in hypocapnia (PCO2 <= 35 mmHg) and presented with more severe brain injury on MRI compared to mild cases. The MRI injury score increased by 6% for each extra hour spent in hypocapnic range in infants with moderate-severe NE. There was no association between hypocapnia and injury scores in mild cases. Conclusion In infants with moderate-severe NE, the hours spent in hypocapnia was an independent predictor of brain injury.

Automated summary

This study aimed to evaluate the association between hypocapnia and brain injury in infants receiving therapeutic hypothermia for neonatal encephalopathy. The results showed that in moderate-severe cases, longer duration of hypocapnia was associated with more severe brain injury on MRI. However, there was no association between hypocapnia and injury scores in mild cases.