Abstract
High-frequency oscillatory ventilation (HFOV) may improve pulmonary outcome in very preterm infants, but the effects on the brain are largely unknown. We hypothesized that early prolonged HFOV compared with low volume positive pressure ventilation (LV-PPV) would not increase the risk of delayed brain growth or injury in a primate model of neonatal chronic lung disease. Baboons were delivered at 127 ± 1 d gestation (dg; term ∼185 dg), ventilated for 22–29 d with either LV-PPV (n = 6) or HFOV (n = 5). Gestational controls were delivered at 153 dg (n = 4). Brains were assessed using quantitative histology. Body, brain, and cerebellar weights were lower in both groups of prematurely delivered animals compared with controls; the brain to body weight ratio was higher in HFOV compared with LV-PPV, and the surface folding index was lower in the LV-PPV compared with controls. In both ventilated groups compared with controls, there was an increase in astrocytes and microglia and a decrease in oligodendrocytes (p < 0.05) in the forebrain and a decrease in cerebellar granule cell proliferation (p < 0.01); there was no difference between ventilated groups. LV-PPV and HFOV ventilation in prematurely delivered animals is associated with decreased brain growth and an increase in subtle neuropathologies; HFOV may minimize adverse effects on brain growth.
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Abbreviations
- dg:
-
days of gestation
- EGL:
-
external granule layer
- FiO2:
-
fraction of inspired oxygen
- H&E:
-
hematoxylin and eosin
- GFAP:
-
glial fibrillary acidic protein
- HFOV:
-
high-frequency oscillatory ventilation
- Iba1:
-
ionized calcium-binding adapter molecule 1
- IGL:
-
inner granule layer
- IR:
-
immunoreactivity
- LV-PPV:
-
low tidal volume positive pressure ventilation
- MBP:
-
myelin basic protein
- ML:
-
molecular layer
- SFI:
-
surface folding index
- WM:
-
white matter
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Acknowledgements
We thank Dr Jaqueline Coalson, Ms Vicki Winter, and staff at the Bronchopulmonary Dysplasia Resource Centre, San Antonio, TX, for provision of baboon tissue and Ms Kathryn Munro for histologic assistance.
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Supported by NIH grants R01 HL074942, HL52636 (in part), and HL52646 (in part).Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.pedresearch.org).
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Loeliger, M., Inder, T., Shields, A. et al. High-Frequency Oscillatory Ventilation Is Not Associated With Increased Risk of Neuropathology Compared With Positive Pressure Ventilation: A Preterm Primate Model. Pediatr Res 66, 545–550 (2009). https://doi.org/10.1203/PDR.0b013e3181bb0cc1
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DOI: https://doi.org/10.1203/PDR.0b013e3181bb0cc1
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