دورية أكاديمية
Intact cord resuscitation in newborns with congenital diaphragmatic hernia: insights from a lamb model
| العنوان: | Intact cord resuscitation in newborns with congenital diaphragmatic hernia: insights from a lamb model |
|---|---|
| المؤلفون: | Baptiste Teillet, Florian Manœuvrier, Céline Rougraff, Capucine Besengez, Laure Bernard, Anne Wojtanowski, Louise Ghesquieres, Laurent Storme, Sébastien Mur, Dyuti Sharma, Kévin Le Duc |
| المصدر: | Frontiers in Pediatrics, Vol 11 (2023) |
| بيانات النشر: | Frontiers Media S.A. |
| سنة النشر: | 2023 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | pulmonary hypoplasia, congenital diaphragmatic hernia (CDH), lamb model, pulmonary hypertension, respiratory—mechanics, Pediatrics, RJ1-570 |
| الوصف: | IntroductionCongenital diaphragmatic hernia (CDH) is a rare condition characterized by pulmonary hypoplasia, vascular dystrophy, and pulmonary hypertension at birth. Validation of the lamb model as an accurate representation of human CDH is essential to translating research findings into clinical practice and understanding disease mechanisms. This article emphasizes the importance of validating the lamb model to study CDH pathogenesis and develop innovative therapeutics.Material and methodsAt 78 days of gestation, the fetal lamb's left forelimb was exposed through a midline laparotomy and hysterotomy, and a supra diaphragmatic thoracotomy was performed to allow the digestive organs to ascend into the thoracic cavity. At 138 ± 3 days of gestation, lambs were delivered via a cesarean section; then, with umbilical cord intact during 1 hour, the lambs were mechanically ventilated with gentle ventilation in a pressure-controlled mode for 2 h.ResultsCDH lambs exhibited a lower left lung-to-body weight ratio of 5.3 (2.03), p < 0.05, and right lung-to-body weight ratio of 8.2 (3.1), p < 0.05. They reached lower Vt/kg (tidal volume per kg) during the course of the resuscitation period with 1.2 (0.7) ml/kg at 10 min and 3 (1.65) ml/kg at 60 min (p < 0.05). Compliance of the respiratory system was lower in CDH lambs with 0.5 (0.3) ml/cmH2O at 60 min (p < 0.05) and 0.9 (0.26) ml/cmH2O at 120 min (p < 0.05). Differences between pre- and postductal SpO2 were higher with 15.1% (21.4%) at 20 min and 6.7% (14.5%) at 80 min (p < 0.05). CDH lambs had lower differences between inspired and expired oxygen fractions with 4.55% (6.84%) at 20 min and 6.72% (8.57%) at 60 min (p < 0.05). CDH lamb had lower left ventricle [2.73 (0.5) g/kg, p < 0.05] and lower right ventricle [0.69 (0.8), p < 0.05] to left ventricle ratio.DiscussionCDH lambs had significantly lower tidal volume than control lambs due to lower compliance of the respiratory system and higher airway resistance. These respiratory changes are ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2296-2360 |
| العلاقة: | https://www.frontiersin.org/articles/10.3389/fped.2023.1236556/fullTest; https://doaj.org/toc/2296-2360Test; https://doaj.org/article/44ede73713bd4b8ca9e9ecdd85dd0f8dTest |
| DOI: | 10.3389/fped.2023.1236556 |
| الإتاحة: | https://doi.org/10.3389/fped.2023.1236556Test https://doaj.org/article/44ede73713bd4b8ca9e9ecdd85dd0f8dTest |
| رقم الانضمام: | edsbas.75733882 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 22962360 |
|---|---|
| DOI: | 10.3389/fped.2023.1236556 |