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
(1) Background: Optimal initial oxygen (O<sub>2</sub>) 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 O<sub>2</sub> exposur...
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doaj-7cdb122e17094d4786e613e28a8d09262021-04-17T23:02:33ZengMDPI AGChildren2227-90672021-04-01830730710.3390/children8040307Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine ModelPraveen Chandrasekharan0Sylvia Gugino1Justin Helman2Carmon Koenigsknecht3Lori Nielsen4Nicole Bradley5Jayasree Nair6Vikash Agrawal7Mausma Bawa8Andreina Mari Torrealba9Munmun Rawat10Satyan Lakshminrusimha11Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USALoma Linda University, Loma Linda, CA 92350, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USADepartment of Pediatrics, Division of Neonatology, University of California Davis School of Medicine, Sacramento, CA 95817, USA(1) Background: Optimal initial oxygen (O<sub>2</sub>) 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 O<sub>2</sub> 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% O<sub>2</sub> and titrated based on preductal saturations (SpO<sub>2</sub>) 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 O<sub>2</sub> (40% ± 20% vs. 60 ± 20%), <i>p</i> < 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 (PaCO<sub>2</sub>) 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 O<sub>2</sub> exposure load improved ventilation with an increase in peak pulmonary blood flow in the first 5 min.https://www.mdpi.com/2227-9067/8/4/307delayed cord clampingoxygen exposurepreterm neonates |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Praveen Chandrasekharan Sylvia Gugino Justin Helman Carmon Koenigsknecht Lori Nielsen Nicole Bradley Jayasree Nair Vikash Agrawal Mausma Bawa Andreina Mari Torrealba Munmun Rawat Satyan Lakshminrusimha |
spellingShingle |
Praveen Chandrasekharan Sylvia Gugino Justin Helman Carmon Koenigsknecht Lori Nielsen Nicole Bradley Jayasree Nair Vikash Agrawal Mausma Bawa Andreina Mari Torrealba Munmun Rawat Satyan Lakshminrusimha 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 delayed cord clamping oxygen exposure preterm neonates |
author_facet |
Praveen Chandrasekharan Sylvia Gugino Justin Helman Carmon Koenigsknecht Lori Nielsen Nicole Bradley Jayasree Nair Vikash Agrawal Mausma Bawa Andreina Mari Torrealba Munmun Rawat Satyan Lakshminrusimha |
author_sort |
Praveen Chandrasekharan |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
MDPI AG |
series |
Children |
issn |
2227-9067 |
publishDate |
2021-04-01 |
description |
(1) Background: Optimal initial oxygen (O<sub>2</sub>) 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 O<sub>2</sub> 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% O<sub>2</sub> and titrated based on preductal saturations (SpO<sub>2</sub>) 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 O<sub>2</sub> (40% ± 20% vs. 60 ± 20%), <i>p</i> < 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 (PaCO<sub>2</sub>) 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 O<sub>2</sub> exposure load improved ventilation with an increase in peak pulmonary blood flow in the first 5 min. |
topic |
delayed cord clamping oxygen exposure preterm neonates |
url |
https://www.mdpi.com/2227-9067/8/4/307 |
work_keys_str_mv |
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