Effect of betamethasone, surfactant, and positive end-expiratory pressures on lung aeration at birth in preterm rabbits.

Autor: Crawshaw JR; The Ritchie Centre, Hudson Institute for Medical Research, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;, Hooper SB; The Ritchie Centre, Hudson Institute for Medical Research, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia; stuart.hooper@monash.edu., Te Pas AB; Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands;, Allison BA; The Ritchie Centre, Hudson Institute for Medical Research, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;, Wallace MJ; The Ritchie Centre, Hudson Institute for Medical Research, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;, Kerr LT; The Ritchie Centre, Hudson Institute for Medical Research, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;, Lewis RA; Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia; Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada; and., Morley CJ; The Royal Women's Hospital, Melbourne, Australia; and., Leong AF; School of Physics and Astronomy, Monash University, Melbourne, Victoria, Australia., Kitchen MJ; School of Physics and Astronomy, Monash University, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2016 Sep 01; Vol. 121 (3), pp. 750-759. Date of Electronic Publication: 2016 Jul 08.
DOI: 10.1152/japplphysiol.01043.2015
Abstrakt: Antenatal glucocorticoids, exogenous surfactant, and positive end-expiratory pressure (PEEP) ventilation are commonly provided to preterm infants to enhance respiratory function after birth. It is unclear how these treatments interact to improve the transition to air-breathing at birth. We investigated the relative contribution of antenatal betamethasone, prophylactic surfactant, and PEEP (3 cmH 2 O) on functional residual capacity (FRC) and dynamic lung compliance (C DL ) in preterm (28 day GA) rabbit kittens at birth. Kittens were delivered by cesarean section and mechanically ventilated. FRC was calculated from X-ray images, and C DL was measured using plethysmography. Without betamethasone, PEEP increased FRC recruitment and C DL Surfactant did not further increase FRC, but significantly increased C DL Betamethasone abolished the benefit of PEEP on FRC, but surfactant counteracted this effect of betamethasone. These findings indicate that low PEEP levels are insufficient to establish FRC at birth following betamethasone treatment. However, surfactant reversed the effect of betamethasone and when combined, these two treatments enhanced FRC recruitment irrespective of PEEP level.
(Copyright © 2016 the American Physiological Society.)
Databáze: MEDLINE
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