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.
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.
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在窒息的早产绵羊模型中，用完整的脊髓复苏增强肺血管舒张和通气，减少全身氧暴露和氧负荷。
DOI：
10.3390/children8040307
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发表时间：
2021-04-17
期刊：
影响因子：
--
通讯作者：
Lakshminrusimha S
中科院分区：
文献类型：
--
作者：
Chandrasekharan P;Gugino S;Helman J;Koenigsknecht C;Nielsen L;Bradley N;Nair J;Agrawal V;Bawa M;Mari A;Rawat M;Lakshminrusimha S
(1)背景：早产儿的最佳初始氧浓度存在争议。我们的目标是比较延迟性脐带夹闭+机械通气(DCCV)和早期脐带夹闭+机械通气(ECCV)对窒息早产绵羊模型中氧气暴露、气体交换和血流动力学的影响。(2)将胎龄127~128日龄、心率<90次/分的早产羔羊随机分为DCCV组和ECCV组。在DCCV模式下，用30-60%O2启动正压通气(PPV)，然后用完整的脐带根据PReductal饱和度(SpO2)滴定5min，然后夹闭。ECCV中，夹住脐带，启动PPV。(3)结果：15只窒息早产羔羊随机分为DCCV组(N=7)和ECCV组(N=8)。DCCV组的吸入O2(40±20%比60±20%，p<；0.05)和氧负荷(520(IQR 414-530)比775(IQR 623-868，P-0.03)显著低于ECCV组。DCCV组的动脉血氧分压和二氧化碳(PaCO2)水平显著降低，峰值肺血流量明显升高。(4)结论：在窒息早产羔羊中，完整的脐带复苏可以减少氧气暴露负荷，改善通气量，增加前5分钟的峰值肺血流量。
(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.
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影响因子：
5.1
作者：
Kapadia, Vishal S.;Chalak, Lina F.;Wyckoff, Myra H.
通讯作者：
Wyckoff, Myra H.
DOI：
10.1038/sj.jp.7210970
发表时间：
2003-09-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Mercer, Judith S;McGrath, Margaret M;Oh, William
通讯作者：
Oh, William
影响因子：
3.6
作者：
Chandrasekharan, Praveen;Rawat, Munmun;Lakshminrusimha, Satyan
通讯作者：
Lakshminrusimha, Satyan
影响因子：
3.6
作者：
Markus, Tina;Hansson, Stefan;Ley, David
通讯作者：
Ley, David
DOI：
10.1111/j.1365-2362.2004.01378.x
发表时间：
2004-07-01
影响因子：
5.5
作者：
Borke, WB;Munkeby, BH;Saugstad, OD
通讯作者：
Saugstad, OD