Cardiovascular and pulmonary consequences of airway recruitment in preterm lambs.

@article{Polglase2009CardiovascularAP,
  title={Cardiovascular and pulmonary consequences of airway recruitment in preterm lambs.},
  author={Graeme R. Polglase and Stuart B. Hooper and Andrew William Gill and Beth J Allison and Carryn J McLean and Ilias Nitsos and J. Jane Pillow and Martin R. Kluckow},
  journal={Journal of applied physiology},
  year={2009},
  volume={106 4},
  pages={
          1347-55
        }
}
Increases in positive end-expiratory pressure (PEEP) improve arterial oxygenation in preterm infants, but the effects on cardiopulmonary hemodynamics are understood poorly. We aimed to determine the effect of increased PEEP on cardiopulmonary hemodynamics and to compare measurements from indwelling flow probes with Doppler echocardiography. Preterm lambs (129 +/- 1 days) were ventilated initially with a tidal volume of 7 ml/kg and 4 cmH(2)O of PEEP. In ramp lambs (n = 7), PEEP was increased by… 
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62 Citations
Background Citations
21
Methods Citations
5
Results Citations
1

62 Citations

Citation Type

Citation Type

Open lung strategy in a lamb model of respiratory distress syndrome.
TLDR
Open lung ventilation following ramp recruitment maneuvers did not offer advantages and might increase lung injury compared with a permissive hypercapnia strategy in preterm lambs with lung immaturity.
Increased peak end-expiratory pressure in ventilated preterm lambs changes cerebral microvascular perfusion: direct synchrotron microangiography assessment.
TLDR
The results suggest that PEEP of 10 cmH2O alters the preterm cerebral haemodynamics, with prolonged cerebral blood flow transit and engorgement of small cerebral microvessels likely due to the increased intrathoracic pressure.
High-CPAP Does Not Impede Cardiovascular Changes at Birth in Preterm Sheep
TLDR
High-CPAP did not impede the increase in PBF at birth and supported preterm lambs without affecting CBF and JVP.
Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits
TLDR
Both PEEP and VT have independent, additive effects on FRC, lung mechanics, and the distribution of ventilation during the immediate newborn period.
Intrauterine inflammation causes pulmonary hypertension and cardiovascular sequelae in preterm lambs.
TLDR
It is concluded that inflammation and pulmonary remodeling induced by IA LPS adversely alters pulmonary hemodynamics with subsequent cardiovascular and systemic sequelae, which may predispose the preterm lamb to persistent pulmonary hypertension of the newborn.
Feasibility and Short-Term Effects of Biphasic Positive Airway Pressure Versus Assist-Control Ventilation in Preterm Lambs
TLDR
In unsedated preterm lambs, BiLevel ventilation provides gas exchange equivalent to A-C ventilation and potentially results in reduced lung injury, and BiLevel group lambs showed improved pressure–volume relationship, lower lung inflammatory score, and trend toward lower messenger RNA expression of markers of lung injury compared with A- C5 group lamBS.
Relationship between Mean Airways Pressure, Lung Mechanics, and Right Ventricular Output during High‐Frequency Oscillatory Ventilation in Infants
Effect of sustained inflation vs. stepwise PEEP strategy at birth on gas exchange and lung mechanics in preterm lambs
TLDR
An SEP at birth improved gas exchange, lung mechanics, and EEV, without increasing lung injury, compared to the SI strategy used.
Dynamic changes in the direction of blood flow through the ductus arteriosus at birth
TLDR
The aim was to describe the changes in PBF and DA flow before, during and after the onset of pulmonary ventilation at birth and reverse DA flow provided a significant contribution to total PBF after birth.
Bi-level CPAP does not change central blood flow in preterm infants with respiratory distress syndrome
TLDR
Central blood flow doesn’t change during bi-level CPAP support, which could become a hemodinamically safe tool for the treatment of RDS in preterm infants.
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