Is extubation associated with changes in ductal and pulmonary blood flow in extremely preterm neonates?

2013 ◽  
Vol 49 (12) ◽  
pp. 1052-1056
Author(s):  
Deepika Wagh ◽  
Andrew Gill
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Preterm Neonates ◽  
Extremely Preterm

Differential effect of recruitment maneuvres on pulmonary blood flow and oxygenation during HFOV in preterm lambs

2008 ◽  
Vol 105 (2) ◽  
pp. 603-610 ◽  
Author(s):  
Graeme R. Polglase ◽  
Timothy J. M. Moss ◽  
Ilias Nitsos ◽  
Beth J. Allison ◽  
J. Jane Pillow ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lung Volume ◽  
Airway Pressure ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Oxygenation Index ◽  
Preterm Neonates ◽  
Mean Airway Pressure ◽  
Lung Volume Recruitment ◽  
High Frequency Oscillatory

The effects of lung volume recruitment manouvres on pulmonary blood flow (PBF) during high-frequency oscillatory ventilation (HFOV) in preterm neonates are unknown. Since increased airway pressure adversely affects PBF, we compared the effects of two HFOV recruitment strategies on PBF and oxygenation index (OI). Preterm lambs (128 ± 1 day gestation; term ∼150 days) were anesthetized and ventilated using HFOV (10 Hz, 33% tI) with a mean airway pressure (Pao) of 15 cmH2O. Lung volume was recruited by either increasing Pao to 25 cmH2O for 1 min, repeated five times at 5-min intervals (Sigh group; n = 5) or stepwise (5 cmH2O) changes in Pao at 5-min intervals incrementing up to 30 cmH2O then decrementing back to 15 cmH2O (Ramp group; n = 6). Controls ( n = 5) received constant HFOV at 15 cmH2O. PBF progressively decreased (by 45 ± 4%) and OI increased (by 15 ± 6%, indicating reduced oxygenation) in controls during HFOV, which was similar to the changes observed in the Sigh group of lambs. In the Ramp group, PBF fell (by 54 ± 10%) as airway pressure increased ( r2 = 0.99), although the PBF did not increase again as the Pao was subsequently reduced. The OI decreased (by 47 ± 9%), reflecting improved oxygenation at high Pao levels during HFOV in the Ramp group. However, high Pao restored retrograde PBF during diastole in four of six lambs, indicating the restoration of right-to-left shunting through the ductus arteriosus. Thus the choice of volume recruitment maneuvre influences the magnitude of change in OI and PBF that occurs during HFOV. Despite significantly improving OI, the ramp recruitment approach causes sustained changes in PBF.

scholarly journals Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 307
Author(s):  
Praveen Chandrasekharan ◽  
Sylvia Gugino ◽  
Justin Helman ◽  
Carmon Koenigsknecht ◽  
Lori Nielsen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Preterm Neonates ◽  
Positive Pressure ◽  
Ovine Model ◽  
Delayed Cord Clamping ◽  
Pulmonary Vasodilation ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Initial Oxygen

(1) Background: Optimal initial oxygen (O2) concentration in preterm neonates is controversial. Our objectives were to compare the effect of delayed cord clamping with ventilation (DCCV) to early cord clamping followed by ventilation (ECCV) on O2 exposure, gas exchange, and hemodynamics in an asphyxiated preterm ovine model. (2) Methods: Asphyxiated preterm lambs (127–128 d) with heart rate <90 bpm were randomly assigned to DCCV or ECCV. In DCCV, positive pressure ventilation (PPV) was initiated with 30–60% O2 and titrated based on preductal saturations (SpO2) with an intact cord for 5 min, followed by clamping. In ECCV, the cord was clamped, and PPV was initiated. (3) Results: Fifteen asphyxiated preterm lambs were randomized to DCCV (N = 7) or ECCV (N = 8). The inspired O2 (40 ± 20% vs. 60 ± 20%, p < 0.05) and oxygen load (520 (IQR 414–530) vs. 775 (IQR 623–868), p-0.03) in the DCCV group were significantly lower than ECCV. Arterial oxygenation and carbon dioxide (PaCO2) levels were significantly lower and peak pulmonary blood flow was higher with DCCV. (4) Conclusion: In asphyxiated preterm lambs, resuscitation with an intact cord decreased O2 exposure load improved ventilation with an increase in peak pulmonary blood flow in the first 5 min.

Noninvasive Investigation of Pulmonary Blood Flow in Children with Pulmonary Hypertension Using the TRV/RVOT VTI Ratio

2017 ◽  
Vol 65 (S 02) ◽  
pp. S111-S142
Author(s):  
M. Koestenberger ◽  
D. Baumgartner ◽  
G. Hansmann ◽  
S. Schweintzger ◽  
G. Grangl ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Hypertension ◽  
Pulmonary Blood Flow

Additional pulmonary blood flow in Glenn anastomosis has no adverse effect on outcome of later TCPC

2004 ◽  
Vol 52 (S 1) ◽  
Author(s):  
PA Berdat ◽  
A Serraf ◽  
E Belli ◽  
F Lacour-Gayet ◽  
C Planch� ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Blood Flow ◽  
Pulmonary Blood Flow
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