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Time to lung aeration during a sustained inflation at birth is influenced by gestation in lambs

Citation

McCall, KE and Waldmann, AD and Pereira-Fantini, P and Oakley, R and Miedema, M and Perkins, EJ and Davis, PG and Dargaville, PA and Bohm, SH and Dellaca, R and Sourial, M and Zannin, E and Rajapaksa, AE and Tan, A and Adler, A and Frerichs, I and Tingay, DG, Time to lung aeration during a sustained inflation at birth is influenced by gestation in lambs, Pediatric Research, 82, (4) pp. 712-720. ISSN 0031-3998 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 International Pediatric Research Foundation

DOI: doi:10.1038/pr.2017.141

Abstract

Background: Current sustained lung inflation (SI) approaches use uniform pressures and durations. We hypothesized that gestational-age-related mechanical and developmental differences would affect the time required to achieve optimal lung aeration, and resultant lung volumes, during SI delivery at birth in lambs.

Methods: 49 lambs, in five cohorts between 118 and 139 days of gestation (term 142 d), received a standardized 40 cmH2O SI, which was delivered until 10 s after lung volume stability (optimal aeration) was visualized on real-time electrical impedance tomography (EIT), or to a maximum duration of 180 s. Time to stable lung aeration (Tstable) within the whole lung, gravity-dependent, and non-gravity-dependent regions, was determined from EIT recordings.

Results: Tstable was inversely related to gestation (P < 0.0001, Kruskal-Wallis test), with the median (range) being 229 (85,306) s and 72 (50,162) s in the 118-d and 139-d cohorts, respectively. Lung volume at Tstable increased with gestation from a mean (SD) of 20 (17) ml/kg at 118 d to 56 (13) ml/kg at 139 d (P = 0.002, one-way ANOVA). There were no gravity-dependent regional differences in Tstable or aeration.

Conclusions: The trajectory of aeration during an SI at birth is influenced by gestational age in lambs. An understanding of this may assist in developing SI protocols that optimize lung aeration for all infants.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Paediatrics and Reproductive Medicine
Research Field:Paediatrics
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Child Health
UTAS Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:123058
Year Published:2017
Web of Science® Times Cited:9
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-12-14
Last Modified:2018-06-26
Downloads:0

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