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Moderate tidal volumes and oxygen exposure during initiation of ventilation in preterm fetal sheep.
MedLine Citation:
PMID:  23037872     Owner:  NLM     Status:  Publisher    
Background:Preterm infants often receive mechanical ventilation and oxygen at birth. Exposure to large tidal volumes (V(T)) at birth causes lung inflammation and oxygen may amplify the injury. We hypothesized that normal V(T) ventilation at birth causes lung injury that is exacerbated by 95% oxygen.Methods:The head and chest of anesthetized preterm fetal sheep (129±1d gestation) were surgically exteriorized while maintaining the placental circulation. Fetuses were randomized to four groups with either: 1) V(T) ventilation to 6 mL/kg or 2) CPAP of 5 cmH(2)O, and either: a) 95%O(2)/5%CO(2) or b) 95%N(2)/5%CO(2). Age-matched fetuses were controls. After a 15-minute intervention, the fetal lamb was returned to the uterus for 1 h 45 min.Results:In ventilated lambs, V(T) was 6.2±0.4 mL/kg at 15 min. Ventilation increased pro-inflammatory cytokines compared to control and CPAP only lambs, with recruitment of primarily monocytes to bronchioalveolar lavage fluid. Early response protein 1 was activated around the bronchioles in V(T) ventilated animals. The 15-min oxygen exposure did not change inflammatory mediators or other markers of lung and oxidative stress.Conclusions:A V(T) of 6-7 mL/kg at birth increased early markers of injury and lung inflammation. Brief exposure to 95% oxygen did not alter lung inflammation.Pediatric Research (2012); doi:10.1038/pr.2012.135.
Noah H Hillman; Timothy J Moss; Ilias Nitsos; Alan H Jobe
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-04
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229.
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