Document Detail


Moderate tidal volumes and oxygen exposure during initiation of ventilation in preterm fetal sheep.
MedLine Citation:
PMID:  23037872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preterm infants often receive mechanical ventilation and oxygen at birth. Exposure to large tidal volumes (V(T)s) 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 ± 1 d gestation) were surgically exteriorized while maintaining the placental circulation. Fetuses were randomized to four groups with either V(T) ventilation to 6 ml/kg or continuous positive airway pressure of 5 cm H2O, and either 95%O2/5%CO2 or 95%N2/5%CO2. Age-matched fetuses were used as controls. After a 15-min 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 proinflammatory cytokines as compared with controls and lambs on continuous positive airway pressure, with recruitment of primarily monocytes to bronchoalveolar 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.
CONCLUSION: 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.
Authors:
Noah H Hillman; Timothy J Moss; Ilias Nitsos; Alan H Jobe
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-04
Journal Detail:
Title:  Pediatric research     Volume:  72     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-19     Completed Date:  2013-06-05     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Immunohistochemistry
In Situ Hybridization
Oxidative Stress
Oxygen / metabolism*
Polymerase Chain Reaction
Respiration, Artificial*
Sheep
Tidal Volume*
Grant Support
ID/Acronym/Agency:
HD-12714/HD/NICHD NIH HHS; K08 HL097085/HL/NHLBI NIH HHS; K08 HL097085/HL/NHLBI NIH HHS; L40 HL086132/HL/NHLBI NIH HHS; R01 HD072842/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
S88TT14065/Oxygen
Comments/Corrections

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