Academic Journal

Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord

التفاصيل البيبلوغرافية
العنوان: Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord
المؤلفون: Jayasree Nair, Lauren Davidson, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Lori Nielsen, Deepika Sankaran, Vikash Agrawal, Praveen Chandrasekharan, Munmun Rawat, Sara K. Berkelhamer, Satyan Lakshminrusimha
المصدر: Children, Vol 8, Iss 5, p 353 (2021)
بيانات النشر: MDPI AG, 2021.
سنة النشر: 2021
المجموعة: LCC:Pediatrics
مصطلحات موضوعية: sustained inflation, delayed cord clamping, placental transfusion, pulmonary blood flow, perinatal asphyxia, Pediatrics, RJ1-570
الوصف: The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation–SI vs. positive pressure ventilation–V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated near-term lambs. We hypothesized that SI with DCC improves gas exchange and hemodynamics in near-term lambs with asphyxial bradycardia. A total of 28 lambs were asphyxiated to a mean blood pressure of 22 mmHg. Lambs were randomized based on the timing of cord clamping (ECC—immediate, DCC—60 s) and mode of initial ventilation into five groups: ECC + V, ECC + SI, DCC, DCC + V and DCC + SI. The magnitude of placental transfusion was assessed using biotinylated RBC. Though an asphyxial bradycardia model, 2–3 lambs in each group were arrested. There was no difference in primary outcomes, the time to reach baseline carotid blood flow (CBF), HR ≥ 100 bpm or MBP ≥ 40 mmHg. SI reduced pulmonary (PBF) and umbilical venous (UV) blood flow without affecting CBF or umbilical arterial blood flow. A significant reduction in PBF with SI persisted for a few minutes after birth. In our model of perinatal asphyxia, an initial SI breath increased airway pressure, and reduced PBF and UV return with an intact cord. Further clinical studies evaluating the timing of cord clamping and ventilation strategy in asphyxiated infants are warranted.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2227-9067
Relation: https://www.mdpi.com/2227-9067/8/5/353; https://doaj.org/toc/2227-9067
DOI: 10.3390/children8050353
URL الوصول: https://doaj.org/article/7390b433341b4f07ae7c97277e6bd466
رقم الانضمام: edsdoj.7390b433341b4f07ae7c97277e6bd466
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:22279067
DOI:10.3390/children8050353