Perfluorocarbons Prevent Lung Injury and Promote Development during Artificial Placenta Support in Extremely Premature Lambs
| Autor: | Raja Rabah, Katherine Boss, Marc B. Hershenson, J. Kelley Bentley, Megan A. Coughlin, Joseph T. Church, Robert H. Bartlett, Jennifer S. McLeod, Elena M. Perkins, George B. Mychaliska |
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| Rok vydání: | 2017 |
| Předmět: |
Amniotic fluid
medicine.medical_treatment Placenta Lung injury Umbilical vein Article 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Pregnancy 030225 pediatrics medicine Extracorporeal membrane oxygenation Animals Lung Fluorocarbons Sheep medicine.diagnostic_test business.industry Histology Lung Injury respiratory system medicine.anatomical_structure Bronchoalveolar lavage 030228 respiratory system Animals Newborn Anesthesia Pediatrics Perinatology and Child Health Female Artificial Organs business Developmental Biology |
| Zdroj: | Neonatology. 113(4) |
| ISSN: | 1661-7819 |
| Popis: | Background: Extremely premature neonates suffer high morbidity and mortality. An artificial placenta (AP) using extracorporeal life support (ECLS) is a promising therapy. Objectives: We hypothesized that intratracheal perfluorocarbon (PFC) instillation during AP support would reduce lung injury and promote lung development relative to intratracheal amniotic fluid or crystalloid. Methods: Lambs at an estimated gestational age (EGA) 116–121 days (term 145 days) were placed on venovenous ECLS with jugular drainage and umbilical vein reinfusion and intubated. Airways were managed by the instillation of amniotic fluid and tracheal occlusion (TO; n = 4), or lactated Ringer’s (LR; n = 4) or perfluorodecalin (a PFC) without occlusion (n = 4). After 7 days, the animals were sacrificed. Early (EGA 116–121 days) and late (EGA 125–131 days) tissue control lambs were delivered and sacrificed. Lungs were formalin-inflated to 30 cm H2O and sectioned for histology. Injury was scored by an unbiased pathologist. Slides were immunostained for PDGFR-α and α-actin; development was quantified by the area fraction of double-positive tips. Surfactant protein-C (SP-C) concentration in bronchoalveolar lavage fluid was quantified using ELISA. Results: Total injury scores were lower in PFC lungs (1.8 ± 1.7) than in TO (6.5 ± 2.1; p = 0.01) and LR lungs (5.5 ± 2.4; p = 0.01). The area fraction of double-positive alveolar tips appeared higher in PFC lungs than in TO lungs (0.18 ± 0.007 vs. 0.008 ± 0.004; p = 0.07). SP-C concentration was higher in PFC lungs than in TO lungs (37.9 ± 7.6 vs. 20.0 ± 5.4 pg/mL; p = 0.005), and both early (12.4 ± 1.7 g/mL; p = 0.007) and late tissue control lungs (15.1 ± 5.0 pg/mL; p = 0.0008). Conclusion: During AP support, intratracheal PFC prevents lung injury and promotes normal lung development better than crystalloid or amniotic fluid with TO. |
| Databáze: | OpenAIRE |
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