Developmental Follow-up of Hyperventilated Neonates: Preliminary Observations

Abstract

A group of 13 newborn infants greater than 37 weeks' gestation were selected to be hyperventilated because of severe hypoxemia refractory to conventional mechanical ventilation, ie, failure to maintain Pao2 > 50 torr with an FIO2 of 1.0, despite Paco2 ≤40 torr and pH ≥7.40. Eleven survived; nine were available for follow-up evaluations. As a group, the nine infants were exposed to a Paco2 ≤20 torr for 51.8 ± 11.8 ( mean ± SEM) hours, to Paco2 ≤15 torr for 11.8 ± 3.3 hours, to a pH ≥7.50 for 64.4 ± 18.6 hours, and to a pH ≥7.60 for 6.1 ± 2.9 hours. One infant was lost to follow-up after a normal assessment at nine months. The other eight infants (seven AGA, one markedly SGA) were at least 1¼ years old at the time of evaluation. The seven AGA infants had a normal developmental quotient (mean 110 [range 96-130] by Stanford-Binet or Bayley assessment); the one SGA infant had a Bayley score of 89. All eight had normal neurologic examinations. These preliminary findings are reassuring with respect to neurologic and developmental outcome following prolonged hyperventilation.