An authentic animal model of the very preterm infant on nasal continuous positive airway pressure

被引：13

作者：

Dargaville P.A. ^{[1
,2
,3
]}

Lavizzari A. ^{[2
,4
]}

Padoin P. ^{[2
,5
]}

Black D. ^{[2
]}

Zonneveld E. ^{[2
]}

Perkins E. ^{[2
]}

Sourial M. ^{[2
]}

Rajapaksa A.E. ^{[2
]}

Davis P.G. ^{[2
,6
]}

Hooper S.B. ^{[7
]}

Moss T.J.M. ^{[7
]}

Polglase G.R. ^{[7
]}

Tingay D.G. ^{[2
,8
]}

机构：

[1] Department of Paediatrics, Royal Hobart Hospital, 48 Liverpool St, Hobart, 7000, TAS

[2] Neonatal Research, Murdoch Childrens Research Institute, Melbourne, VIC

[3] Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS

[4] NICU, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico-Università degli Studi di Milano, Milan

[5] Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre

[6] Newborn Research, The Royal Women’s Hospital, Melbourne, VIC

[7] The Ritchie Centre, Monash Institute of Medical Research and Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC

[8] Neonatal Unit, Royal Children’s Hospital, Melbourne

来源：

Intensive Care Medicine Experimental | / 3卷 / 1期

关键词：

Apnoea; Continuous positive airway pressure; Non-invasive positive pressure ventilation; Preterm lamb;

D O I：

10.1186/s40635-015-0051-4

中图分类号：

学科分类号：

摘要：

Background: The surge in uptake of nasal continuous positive airway pressure (CPAP) for respiratory support in preterm infants has occurred in the absence of an authentic animal model. Such a model would allow investigation of research questions of physiological and therapeutic importance. We therefore aimed to develop a preterm lamb model of the non-intubated very preterm infant on CPAP. Methods: After staged exteriorisation and instrumentation, preterm lambs were delivered from anaesthetised ewes at 131 to 133 days gestation. Via a single nasal prong (4-mm internal diameter, 6- to 7-cm depth), positive pressure was delivered from the outset, with nasal intermittent positive pressure ventilation (NIPPV) used until transition to nasal CPAP was attempted, and periodically thereafter for hypoventilation. Caffeine and doxapram were used as respiratory stimulants. Gastric distension was prevented with an oesophageal balloon. Cardiorespiratory parameters and results of arterial blood gas analyses were monitored throughout the study period, which continued for 150 min after first transition to CPAP. Results: Ten preterm lambs were studied, at gestation 132 ± 1 days (mean ± SD) and birth weight 3.6 ± 0.45 kg. After stabilisation on NIPPV, transition to nasal CPAP was first attempted at 28 ± 11 min. There was transient respiratory acidosis, with gradual resolution as spontaneous respiratory activity increased. In the final hour, 79% ± 33% of time was spent on CPAP alone, with typical respiratory rates around 60 breaths per minute. PaCO2 at end-experiment was 58 ± 36 mmHg. Conclusions: Non-intubated preterm lambs can be effectively transitioned to nasal CPAP soon after birth. This animal model will be valuable for further research. © 2015, Dargaville et al.; licensee Springer.

引用

页数：12

共 25 条

[1]

te Pas A.B., Walther F.J., A randomized, controlled trial of delivery-room respiratory management in very preterm infants, Pediatrics, 120, pp. 322-329, (2007)

[2]

Gopel W., Kribs A., Ziegler A., Laux R., Hoehn T., Wieg C., Siegel J., Avenarius S., von der Wense A., Vochem M., Groneck P., Weller U., Moller J., Hartel C., Haller S., Roth B., Herting E., Avoidance of mechanical ventilation by surfactant treatment of spontaneously breathing preterm infants (AMV): an open-label, randomised, controlled trial, Lancet, 378, pp. 1627-1634, (2011)

[3]

Dargaville P.A., Aiyappan A., De Paoli A.G., Kuschel C.A., Kamlin C.O., Carlin J.B., Davis P.G., Minimally-invasive surfactant therapy in preterm infants on continuous positive airway pressure, Arch Dis Child Fetal Neonatal Ed, 98, pp. 122-126, (2013)

[4]

Schmidt B., Roberts R.S., Davis P., Doyle L.W., Barrington K.J., Ohlsson A., Solimano A., Tin W., Caffeine therapy for apnea of prematurity, N Engl J Med, 354, pp. 2112-2121, (2006)

[5]

Crossley K.J., Allison B.J., Polglase G., Morley C.J., Harding R., Davis P.G., Moss T.J., Hooper S.B., Effects of caffeine on renal and pulmonary function in preterm newborn lambs, Pediatr Res, 72, pp. 19-25, (2012)

[6]

Mulrooney N., Champion Z., Moss T.J., Nitsos I., Ikegami M., Jobe A.H., Surfactant and physiologic responses of preterm lambs to continuous positive airway pressure, Am J Respir Crit Care Med, 171, pp. 488-493, (2005)

[7]

Jobe A.H., Kramer B.W., Moss T.J., Newnham J.P., Ikegami M., Decreased indicators of lung injury with continuous positive expiratory pressure in preterm lambs, Pediatr Res, 52, pp. 387-392, (2002)

[8]

Pillow J.J., Hillman N., Moss T.J., Polglase G., Bold G., Beaumont C., Ikegami M., Jobe A.H., Bubble continuous positive airway pressure enhances lung volume and gas exchange in preterm lambs, Am J Respir Crit Care Med, 176, pp. 63-69, (2007)

[9]

Polglase G.R., Hillman N.H., Ball M.K., Kramer B.W., Kallapur S.G., Jobe A.H., Pillow J.J., Lung and systemic inflammation in preterm lambs on continuous positive airway pressure or conventional ventilation, Pediatr Res, 65, pp. 67-71, (2009)

[10]

Thomson M.A., Yoder B.A., Winter V.T., Martin H., Catland D., Siler-Khodr T.M., Coalson J.J., Treatment of immature baboons for 28 days with early nasal continuous positive airway pressure, Am J Respir Crit Care Med, 169, pp. 1054-1062, (2004)

← 1 2 3 →