Document Detail


Surfactant and physiologic responses of preterm lambs to continuous positive airway pressure.
MedLine Citation:
PMID:  15502113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although continuous positive airway pressure (CPAP) is used frequently for preterm infants, the relationships between the amount of surfactant and lung physiologic and injury responses to CPAP are unknown. Therefore, saturated phosphatidylcholine (Sat PC) was measured to quantify the surfactant necessary for preterm lambs to breathe successfully on a CPAP of 5 cm H(2)O (CPAP 5). Five of 21 lambs delivered at 130-136 days gestation failed to keep PCO(2) below 100 mm Hg by 2 hours. The lambs that failed had less than 1.9 micromol/kg Sat PC in bronchoalveolar fluid (approximately 3% the pool size at term), less surfactant secretion, and less large aggregate surfactant. Physiologic responses of other 132-day preterm lambs after 2 or 6 hours of CPAP 5, 8 cm H(2)O CPAP (CPAP 8), or mechanical ventilation were then characterized. At 6 hours, oxygenation and lung gas volumes were higher with CPAP 8 relative to the other groups and VE was decreased with CPAP 8 relative to CPAP 5. Lung dry/wet ratios were greater for the CPAP groups than for the mechanical ventilation group. A small amount of endogenous Sat PC is required for preterm lambs to breathe successfully with CPAP. CPAP 8 improves early newborn respiratory transition relative to CPAP 5.
Authors:
Neil Mulrooney; Zahra Champion; Timothy J M Moss; Ilias Nitsos; Machiko Ikegami; Alan H Jobe
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2004-10-22
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  171     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-21     Completed Date:  2005-04-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  488-93     Citation Subset:  AIM; IM    
Affiliation:
Cincinnati Children's Hospital, Division of Pulmonary Biology, University of Cincinnati School of Medicine, Ohio 45229-3039, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Animals
Animals, Newborn
Biological Markers / analysis,  metabolism
Continuous Positive Airway Pressure*
Disease Models, Animal
Gestational Age
Humans
Infant, Newborn
Infant, Premature, Diseases / metabolism*,  physiopathology,  therapy*
Pulmonary Surfactants / metabolism*
Reference Values
Respiratory Function Tests
Respiratory Insufficiency / metabolism*,  physiopathology,  therapy*
Sheep
Survival Analysis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HD-12714/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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