Abstract
In 22 newborn piglets we studied the effect of hypovolemia or hypoxemia on hemodynamics and regional blood flow after instillation of porcine surfactant. Surfactant deficiency was obtained by repeated lung lavage, and blood flow measurements were carried out using radioactive microspheres. Three groups of piglets were studied, controls (n = 8), hypovolemia (n = 7), and hypoxemia (n = 7). Three to five minutes after instillation of surfactant, mean arterial blood pressure decreased significantly in all three groups with a mean decrease (±SD) of 31(±12), 33(±9), and 29(±9) mm Hg, respectively (p < 0.01 in all three groups). Systemic vascular resistance decreased significantly in all three groups immediately after surfactant instillation (p < 0.01) and returned to presurfactant level after 60 min. Blood flow did not change after surfactant instillation in any of the three groups, in neither skin, muscle, pancreas, brain, nor retina. In liver, kidney, intestine, and choroidea there was a decrease in blood flow immediately after instillation with return to presurfactant levels within 60 min. Hypoxemia or hypovolemia before surfactant instillation did not increase the hemodynamic instability. The decrease in mean arterial blood pressure was caused by a vasodilation and not by a reduced cardiac output.
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Abbreviations
- a/A ratio:
-
arterial/alveolar ratio of oxygen tension
- ANOVA:
-
analysis of variance
- CBF:
-
cerebral blood flow
- CBFV:
-
cerebral blood flow velocity
- CBV:
-
cerebral blood volume
- CMRo2:
-
cerebral metabolic rate for oxygen
- CVP:
-
central venous pressure
- CVR:
-
cerebral vascular resistance
- Fio2:
-
fraction of inspired oxygen
- IVH:
-
intraventricular hemorrhage
- MABP:
-
mean arterial blood pressure
- Paco2:
-
arterial tension of carbon dioxide
- Pao2:
-
arterial tension of oxygen
- PIP:
-
peak inspiratory pressure
- presurf:
-
presurfactant
- PWM:
-
periventricular white matter
- RDS:
-
respiratory distress syndrome
- ROP:
-
retinopathy of prematurity
- SVR:
-
systemic vascular resistance
- Sao2:
-
saturation of oxygen
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Acknowledgements
The authors thank Ellen Lund Sagen and RogerØdegård for skillfull technical assistance.
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Supported with grants from The Norwegian Research Council, Medinnova, Nelsons Legat, Norwegian Perinatal Association, The Swedish Medical Research Council (project 3351), Oscar II's Jubileumsfond, and Serono Nordic AB.
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Moen, A., Rootwelt, T., Robertson, B. et al. Hemodynamics and Tissue Blood Flow after Porcine Surfactant Replacement in Surfactant-Depleted Newborn Piglets. Pediatr Res 40, 215–224 (1996). https://doi.org/10.1203/00006450-199608000-00006
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DOI: https://doi.org/10.1203/00006450-199608000-00006
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