Abstract
The optimal Fio2 during neonatal resuscitation is a subject of controversy. The effect of exposure to high levels of inspired oxygen on pulmonary arterial (PA) contractility is not known. We studied differences in PA vasoreactivity in term lambs initially ventilated with 21% or 100% oxygen, followed by continued ventilation using oxygen as needed for 24 h, or ventilated with 100% oxygen for 24 h and room air breathing 1-d-old lambs. Term lambs were delivered by cesarean section, intubated, and ventilated with 21% (21%Res) or 100% oxygen (100%Res) for the first 30 min of life. Subsequently, the ventilator Fio2 was adjusted to maintain a Pao2 between 45 and 65 mm Hg for 24 h. Five lambs were ventilated continuously with 100% oxygen (100%24h). Six spontaneously breathing newborn lambs (RA Spont) were studied for comparison. Lambs were killed at 24 h of life and PA rings were isolated and contracted with norepinephrine (NE) and KCl and some were relaxed with A23187 and SNAP in tissue baths. NE and KCl induced contractions were highest in PA isolated from 100%24h lambs, and were significantly higher in 100%Res lambs than PA from 21%Res lambs. Contraction responses in PA from RA Spont lambs were similar to 21%Res lambs. Relaxations to A23187 and SNAP were similar among all ventilated groups. PA contractility to NE and KCl is increased following both brief (30 min) and prolonged (24 h) exposure to 100% oxygen during mechanical ventilation. In contrast, normoxic resuscitation and ventilation do not increase PA contractility.
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Abbreviations
- LNA:
-
Nω nitro-l-arginine
- NE:
-
norepinephrine
- PAo2:
-
alveolar partial pressure of oxygen
- PPHN:
-
persistent pulmonary hypertension of newborn
- SNAP:
-
nitric oxide donor S-nitrosyl amino penicillamine
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Acknowledgements
The authors thank Karen Wynn, NNP, Huamei Wang, M.D., Nasir Rashid, M.D., Margaret Brick, Jan Capell, RN, and Sharon Baumgartner for their expert technical assistance during ventilation studies.
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Funded by American Academy of Pediatrics/Neonatal Resuscitation Program Grant # 1040244 (V.H.K.) and HL#54705 (R.H.S.).
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Lakshminrusimha, S., Russell, J., Steinhorn, R. et al. Pulmonary Arterial Contractility in Neonatal Lambs Increases with 100% Oxygen Resuscitation. Pediatr Res 59, 137–141 (2006). https://doi.org/10.1203/01.pdr.0000191136.69142.8c
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DOI: https://doi.org/10.1203/01.pdr.0000191136.69142.8c
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