Resuscitation with an Intact Cord Enhances Pulmonary Vasodilation and Ventilation with Reduction in Systemic Oxygen Exposure and Oxygen Load in an Asphyxiated Preterm Ovine Model
Praveen Chandrasekharan,
Sylvia Gugino,
Justin Helman,
Carmon Koenigsknecht,
Lori Nielsen,
Nicole Bradley,
Jayasree Nair,
Vikash Agrawal,
Mausma Bawa,
Andreina Mari,
Munmun Rawat,
Satyan Lakshminrusimha
Affiliations
Praveen Chandrasekharan
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Sylvia Gugino
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Justin Helman
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Carmon Koenigsknecht
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Lori Nielsen
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Nicole Bradley
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Jayasree Nair
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Vikash Agrawal
Department of Pediatrics, Loma Linda University, Loma Linda, CA 92350, USA
Mausma Bawa
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Andreina Mari
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Munmun Rawat
Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14260, USA
Satyan Lakshminrusimha
Department of Pediatrics, Division of Neonatology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
(1) Background: Optimal initial oxygen (O2) concentration in preterm neonates is controversial. Our objectives were to compare the effect of delayed cord clamping with ventilation (DCCV) to early cord clamping followed by ventilation (ECCV) on O2 exposure, gas exchange, and hemodynamics in an asphyxiated preterm ovine model. (2) Methods: Asphyxiated preterm lambs (127–128 d) with heart rate 2 and titrated based on preductal saturations (SpO2) with an intact cord for 5 min, followed by clamping. In ECCV, the cord was clamped, and PPV was initiated. (3) Results: Fifteen asphyxiated preterm lambs were randomized to DCCV (N = 7) or ECCV (N = 8). The inspired O2 (40 ± 20% vs. 60 ± 20%, p 2) levels were significantly lower and peak pulmonary blood flow was higher with DCCV. (4) Conclusion: In asphyxiated preterm lambs, resuscitation with an intact cord decreased O2 exposure load improved ventilation with an increase in peak pulmonary blood flow in the first 5 min.
