期刊
CHILDREN-BASEL
卷 8, 期 4, 页码 -出版社
MDPI
DOI: 10.3390/children8040307
关键词
delayed cord clamping; oxygen exposure; preterm neonates
类别
资金
- NICHD [R03HD096510, RO1 HD072929, NHLBI-K12 HL138052]
In asphyxiated preterm lambs, resuscitation with delayed cord clamping and ventilation (DCCV) significantly reduced oxygen exposure load, improved ventilation, and increased peak pulmonary blood flow.
(1) Background: Optimal initial oxygen (O-2) 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-2 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-2 and titrated based on preductal saturations (SpO(2)) 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-2 (40 +/- 20% vs. 60 +/- 20%, p < 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 (PaCO2) 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-2 exposure load improved ventilation with an increase in peak pulmonary blood flow in the first 5 min.
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