scholarly journals Greater sympathoadrenal activation with longer cord clamp-to-ventilation intervals after immediate cord clamping increases haemodynamic lability after birth in preterm lambs

2017 ◽  
Vol 53 ◽  
pp. 94-94
Keyword(s):  
Sympathoadrenal Activation ◽  
Cord Clamping

Blunted sympathoadrenal activation accompanies hemodynamic stability after early ventilation and delayed cord clamping at birth in preterm lambs

2019 ◽  
Vol 86 (4) ◽  
pp. 478-484 ◽  
Author(s):  
Joseph J. Smolich ◽  
Kelly R. Kenna ◽  
Jonathan P. Mynard ◽  
Sarah E. Phillips ◽  
Gavin W. Lambert
Keyword(s):  
Delayed Cord Clamping ◽  
Hemodynamic Stability ◽  
Sympathoadrenal Activation ◽  
Cord Clamping

Greater sympathoadrenal activation with longer preventilation intervals after immediate cord clamping increases hemodynamic lability at birth in preterm lambs

2017 ◽  
Vol 312 (6) ◽  
pp. R903-R911 ◽  
Author(s):  
Joseph J. Smolich ◽  
Kelly R. Kenna ◽  
Murray D. Esler ◽  
Sarah E. Phillips ◽  
Gavin W. Lambert
Keyword(s):  
Heart Rate ◽  
Cardiac Contractility ◽  
Pressure Rise ◽  
Ventricular Contractility ◽  
Sympathoadrenal Activation ◽  
Cord Clamping ◽  
Before And After ◽  
Blood Pressures ◽  
Surrogate Measure ◽  
Catecholamine Levels

This study tested the hypothesis that varying degrees of hemodynamic fluctuations seen after birth following immediate cord clamping were related to development of asphyxia with longer cord clamp-to-ventilation intervals, resulting in higher perinatal circulating levels of the catecholamines norepinephrine (NE) and epinephrine (Epi), and thus increased heart rate, blood pressures, and cardiac contractility after birth. Anesthetized preterm fetal lambs were instrumented with 1) aortic (AoT) and pulmonary trunk (PT) micromanometers to obtain pressures and the maximal rate of pressure rise (dP/d tmax) as a surrogate measure of ventricular contractility, and 2) an AoT catheter to obtain samples for blood gas and catecholamine analyses. After delivery, immediate cord clamping was followed by ventilation ∼40 s ( n = 7), ∼60 s ( n = 8), ∼90 s ( n = 9), or ∼120 s later ( n = 8), with frequent blood sampling performed before and after ventilation. AoT O2content fell rapidly after immediate cord clamping ( P < 0.001), with an asphyxial state evident at ≥60 s. Plasma NE and Epi levels increased progressively with longer cord clamp-to-ventilation intervals, with an exponential relation between falling AoT O2content and rising catecholamines ( R2 = 0.64–0.67). Elevated circulating catecholamines persisted for some minutes after ventilation onset, with postbirth surges in heart rate, AoT and PT pressures, and AoT and PT dP/d tmaxlinearly related to logeof catecholamine levels ( R2 = 0.41–0.54, all P < 0.001). These findings suggest that 1) a greater degree of asphyxia-induced sympathoadrenal activation (reflected in elevated circulating catecholamine levels) occurs with longer intervals between immediate cord clamping and subsequent ventilation, and 2) this activation is a major determinant of hemodynamic fluctuations evident with birth.

Obstetrical and neonatal factors associated with optimal public banking of umbilical cord blood in the context of delayed cord clamping

2019 ◽  
Vol 42 (3) ◽  
pp. E56-E63 ◽  
Author(s):  
Anna Munro ◽  
Daniel J. Corsi ◽  
Lisa Martin ◽  
Michael Halpenny ◽  
Nicholas Dibdin ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Delayed Cord Clamping ◽  
Factors Associated ◽  
Cell Counts ◽  
Cord Clamping ◽  
Newborn Weight ◽  
Cord Blood Banks

Purpose: To assess the association of specific newborn and maternal factors with indicators of increased blood-forming capacity in umbilical cord blood to inform strategic collection strategies that could augment the quality of units in public cord blood banks. Methods: Data regarding 268 consecutive cord blood units (CBUs) banked by Canadian Blood Services were analyzed. Multivariate analysis was performed to identify factors associated with markers of hematopoietic potency and likelihood of utilization. Results: Delayed clamping of the cord beyond 60 s was associated with reduced volume collected. Any delay in clamping of the cord was associated with reduced total nucleated cell counts. Newborn weight >4,000 g was also associated with greater blood volume in the collection but not with other measures of hematopoietic potency. Cord blood acidosis at birth (pH

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