Intubated and ventilated asphyxiated newborns experienced more severe hypocapnia, and had higher incidences of brain injury. Hypocapnia during the first 4 days of life was associated with an increased risk of developing (more severe) brain injury.

No abstract

Abstract"irth asphyxia and the resulting neonatal encephalopathy are a significant cause of mortality and long-term morbidity in children. Hypothermia is currently the only neuroprotective treatment to have been clinically tested in large trials to prevent the development of brain injury in some term asphyxiated newborns. Most of the asphyxiated newborns treated with hypothermia are intubated at birth as per resuscitation measures and remain on mechanical ventilation during some part of the hypothermia treatment or during the whole length of the treatment. They also may present with oxygenation problems. Very often, they present with hypocapnia that can be worsened with the use of mechanical ventilation during the first days of life. When taking care of these newborns, a few important points should be remembered about the impact of asphyxia and therapeutic hypothermia on oxygenation and ventilation. In this article, we review some of the physiopathology behind neonatal encephalopathy and the implications of brain cooling from a respiratory point of view. Strategies to optimize oxygenation and ventilation for these newborns, as well as to prevent further brain injury, are also discussed based on a current literature review.

Background Advancing maternal age is increasingly prevalent and is associated with severe maternal morbidity often requiring intensive care unit (ICU) admission. Objectives To describe maternal ICU admissions at a quaternary care hospital in Montreal, Canada, and evaluate the association between maternal age and composite of: need for invasive interventions, ICU stay > 48 h, or maternal death. Methods Chart review of ICU admissions during pregnancy/postpartum (2006–2016); logistic regressions to evaluate the impact of age on outcomes. Results With 5.1 ICU admissions per 1000 deliveries, we included 187 women (mean age 32 ± 6.3 years; 20 (10.7%) ≥ 40 years). The composite outcome occurred in 105 (56.2%) patients; there were two maternal deaths. Age ≥ 40 years increased the odds of invasive interventions (OR 4.03; 95% confidence interval [CI] 1.15–14.1) but not of the composite outcome (OR 2.30; 95% CI 0.66–8.02). Conclusion Peripartum women aged ≥ 40 years had worse outcomes in ICU, with an increased need for invasive interventions.