The cardiopulmonary benefits of physiologically based cord clamping persist for at least 8 hours in lambs with a diaphragmatic hernia

Bibliographic Details
Title: The cardiopulmonary benefits of physiologically based cord clamping persist for at least 8 hours in lambs with a diaphragmatic hernia
Authors: Paige J. Riddington, Philip L. J. DeKoninck, Marta Thio, Calum T. Roberts, Risha Bhatia, Janneke Dekker, Aidan J. Kashyap, Benjamin J. Amberg, Karyn A. Rodgers, Alison M. Thiel, Ilias Nitsos, Valerie A. Zahra, Ryan J. Hodges, Stuart B. Hooper, Kelly J. Crossley
Source: Frontiers in Pediatrics, Vol 12 (2024)
Publisher Information: Frontiers Media S.A., 2024.
Publication Year: 2024
Collection: LCC:Pediatrics
Subject Terms: congenital diaphragmatic hernia, lung hypoplasia, neonatal transition, pulmonary hypertension, pulmonary blood flow, pulmonary vascular resistance, Pediatrics, RJ1-570
More Details: IntroductionInfants with congenital diaphragmatic hernia can suffer severe respiratory insufficiency and pulmonary hypertension after birth. Aerating the lungs before removing placental support (physiologically based cord clamping, PBCC) increases pulmonary blood flow (PBF) and reduces pulmonary vascular resistance (PVR) in lambs with a diaphragmatic hernia (DH). We hypothesized that these benefits of PBCC persist for at least 8 h after birth.MethodsAt ∼138 days of gestation age (dGA), 21 lambs with a surgically induced left-sided DH (∼86 dGA) were delivered via cesarean section. The umbilical cord was clamped either before ventilation onset (immediate cord clamping, ICC, n = 9) or after achieving a tidal volume of 4 ml/kg, with a maximum delay of 10 min (PBCC, n = 12). The lambs were ventilated for 8 h, initially with conventional mechanical ventilation, but were switched to high-frequency oscillatory ventilation after 30 min if required. Ventilatory parameters, cardiopulmonary physiology, and arterial blood gases were measured throughout the study.ResultsPBF increased after ventilation onset in both groups and was higher in the PBCC DH lambs than the ICC DH lambs at 8 h (5.2 ± 1.2 vs. 1.9 ± 0.3 ml/min/g; p
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-2360
Relation: https://www.frontiersin.org/articles/10.3389/fped.2024.1451497/full; https://doaj.org/toc/2296-2360
DOI: 10.3389/fped.2024.1451497
Access URL: https://doaj.org/article/69fc9b014f1a4a168ca6cce912e71191
Accession Number: edsdoj.69fc9b014f1a4a168ca6cce912e71191
Database: Directory of Open Access Journals
More Details
ISSN:22962360
DOI:10.3389/fped.2024.1451497
Published in:Frontiers in Pediatrics
Language:English