Blood Gas Interpretation Under Hypothermic Conditions: A Comparative Study of Alpha‐Stat and pH‐Stat in Neonatal Hypoxic–Ischemic Encephalopathy

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Introduction Acid‐base management in neonates with hypoxic–ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH) can use either the “alpha‐stat” or the “pH‐stat” method, which adjusts values based on temperature. Objective This study aimed to compare the efficacy of two blood gas analysis techniques in predicting the severity of brain injury in neonates with HIE. Method A retrospective study was conducted on neonates over 35 weeks’ gestation who underwent TH between 2010 and 2015. Diagnostic, univariate, and multivariate analyses were performed to compare outcomes between the alpha‐sat and pH‐stat groups. Results Adjusting for sex and age, the odds ratios for being classified as hypocapnic were 4.40 (95% CI: 1.19–16.27) using the alpha‐stat method and 2.94 (95% CI 1.15–26.48) using the pH‐stat method. The classification of patients as hypocapnic, normocapnic, or hypercapnic differed significantly between the two methods ( p < 0.0001), with 23% of patients reclassified from the alpha‐stat to the pH‐stat method. Conclusion Both blood gas analysis methods were similarly effective in predicting brain injury extent. However, the alpha‐stat method significantly overestimated the lowest pCO 2 values during therapeutic hypothermia.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.