Importance of blood gas measurements in perinatal asphyxia and alternatives to restore the acid base balance status to improve the newborn performance

Abstract

Prolonged or intermittent asphyxia in utero and during farrowing weakens piglets and renders them less capable of adaptation to extrauterine life. Piglets with lesser viability at birth have increased blood pCO2 and blood lactic acid concentrations and decreased blood pH. Moreover, the ability to thermoregulate during an acute cold stress is inversely related to umbilical blood lactate concentrations. Blood gas measurements and noninvasive estimations provide important information about oxygenation. The general goals of oxygen therapy in the neonate are to maintain adequate arterial PaO2 and SaO2, and to minimize cardiac work and the work of breathing. Arterial blood gas determinations of pCO2 provide the most accurate determinations of the adequacy of alveolar ventilation. Blood gases obtained in the immediate perinatal period can help assess perinatal asphyxia, but particular attention must be paid to the sampling site, the time of life, and the possible and proven diagnoses. The decision to obtain blood gases must be weighed by the individual clinician against the potential benefits. Current measures for restoring the acid base balance status in the newborn with perinatal asphyxia are discussed.