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Cardiovascular changes during sustained lung inflations in premature newborn lambs
W A Klöpping-Ketelaars1, W J Maertzdorf, C E Blanco
1Department of Neonatology, University of Limburg, Maastricht, The Netherlands.
Acta Paediatrica (Oslo, Norway : 1992)
|September 1, 1994
Summary
Sustained inspiratory inflations (SI) temporarily altered cardiovascular parameters in premature lambs. These findings are relevant for managing high-risk premature infants, particularly concerning intraventricular hemorrhage.
Area of Science:
- Neonatal Physiology
- Cardiovascular Research
- Respiratory Medicine
Background:
- Premature infants face risks of cardiovascular instability.
- Intraventricular hemorrhage is a significant concern in preterm neonates.
- Understanding the impact of respiratory interventions is crucial.
Purpose of the Study:
- To investigate the cardiovascular effects of sustained inspiratory inflations (SI) in premature lambs.
- To measure changes in mean central venous pressure (MCVP), mean arterial blood pressure (MABP), and heart rate (HR) during SI.
- To assess the clinical relevance of these cardiovascular changes for managing high-risk premature infants.
Main Methods:
- Measurements of MCVP, MABP, and HR were taken before and during SI in premature lambs (128-133 days' gestation).
- SI involved four 5-second inflations at 35 cmH2O with a 5% CO2/95% O2 mixture, followed by 5 cmH2O positive end-expiratory pressure.
- Cardiovascular responses were analyzed in relation to gestational age and inflation pressure.
Main Results:
- Mean arterial blood pressure decreased by -3.88% and heart rate by -2.55% during the first inflation.
- Mean central venous pressure showed significant fluctuations, increasing by 9.61% (p < 0.01) during inflation and decreasing by -3.87% (p < 0.05) during deflation.
- Cardiovascular changes were dependent on the lamb's age and the applied SI pressure.
Conclusions:
- Sustained inspiratory inflations induce notable cardiovascular changes in premature lambs.
- These observed hemodynamic effects are clinically relevant for the respiratory management of premature infants.
- The findings suggest a need for careful monitoring of cardiovascular status during SI in high-risk neonates to mitigate risks like intraventricular hemorrhage.