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Different responses of myocardial and cerebral blood flow to cord occlusion in exteriorized fetal sheep

Ley, David LU ; Oskarsson, G; Bellander, M; Hernandez-Andrade, Edgar LU ; Lingman, Göran LU ; Marsal, Karel LU ; Olsson, T; Pesonen, Erkki LU ; Thorngren-Jerneck, Kristina LU and Werner, Olof LU , et al. (2004) In Pediatric Research 55(4). p.568-575
Abstract
Type and duration of fetal asphyxial insult affect the distribution of blood flow to the heart and brain. The purpose of this study was to describe dynamic and quantitative changes in regional myocardial and cerebral blood flow (CBF) during fetal asphyxia induced by total occlusion of the umbilical cord. Eleven exteriorized fetal sheep were subjected to total umbilical cord occlusion and five fetal sheep served as sham controls. Regional blood flow (BF) to the brain and heart was quantified using radioactive microspheres before and after 5 min of occlusion and finally when fetal mean arterial blood pressure had decreased below 25 mm Hg, 9.8 (0.8) [mean (SD)] min after occlusion. Right coronary arterial (RCA) blood flow velocity and carotid... (More)
Type and duration of fetal asphyxial insult affect the distribution of blood flow to the heart and brain. The purpose of this study was to describe dynamic and quantitative changes in regional myocardial and cerebral blood flow (CBF) during fetal asphyxia induced by total occlusion of the umbilical cord. Eleven exteriorized fetal sheep were subjected to total umbilical cord occlusion and five fetal sheep served as sham controls. Regional blood flow (BF) to the brain and heart was quantified using radioactive microspheres before and after 5 min of occlusion and finally when fetal mean arterial blood pressure had decreased below 25 mm Hg, 9.8 (0.8) [mean (SD)] min after occlusion. Right coronary arterial (RCA) blood flow velocity and carotid BF were registered continuously. Mean values of arterial pH and oxygen content (mL O-2/100 mL) were 7.08 (0.11) and 4.4 (2.9) before cord occlusion and decreased to 6.83 (0.05) and 1.4 (0.9) at 5 min after occlusion (p < 0.01, respectively). Carotid BF was significantly below preocclusion values by 2.5 min (p < 0.05), whereas RCA velocity time integral per minute remained above preocclusion values for 9 min. CBF decreased from 316 (24) before cord occlusion to 156 (30) mL/min/100 g at 5 min (p < 0.01), whereas right myocardial BF was maintained at 792 (125) and 751 (183) mL/min/100 g, respectively. CBF decreased rapidly after total cord occlusion whereas myocardial BF increased and was maintained until shortly before cardiac arrest, suggesting the myocardium to be better preserved during this type of insult in already partially asphyxiated fetuses. (Less)
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Contribution to journal
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published
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Pediatric Research
volume
55
issue
4
pages
568 - 575
publisher
International Pediatric Foundation Inc.
external identifiers
  • pmid:14739362
  • wos:000220478700007
  • scopus:12144285864
ISSN
1530-0447
DOI
10.1203/01.PDR.0000113785.66455.E7
language
English
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yes
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49e0f5e5-239f-43fe-b378-1cc0420a14e3 (old id 283565)
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http://www.pedresearch.org/pt/re/pedresearch/fulltext.00006450-200404000-00007.htm
date added to LUP
2007-10-24 18:19:16
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2017-06-25 03:45:05
@article{49e0f5e5-239f-43fe-b378-1cc0420a14e3,
  abstract     = {Type and duration of fetal asphyxial insult affect the distribution of blood flow to the heart and brain. The purpose of this study was to describe dynamic and quantitative changes in regional myocardial and cerebral blood flow (CBF) during fetal asphyxia induced by total occlusion of the umbilical cord. Eleven exteriorized fetal sheep were subjected to total umbilical cord occlusion and five fetal sheep served as sham controls. Regional blood flow (BF) to the brain and heart was quantified using radioactive microspheres before and after 5 min of occlusion and finally when fetal mean arterial blood pressure had decreased below 25 mm Hg, 9.8 (0.8) [mean (SD)] min after occlusion. Right coronary arterial (RCA) blood flow velocity and carotid BF were registered continuously. Mean values of arterial pH and oxygen content (mL O-2/100 mL) were 7.08 (0.11) and 4.4 (2.9) before cord occlusion and decreased to 6.83 (0.05) and 1.4 (0.9) at 5 min after occlusion (p &lt; 0.01, respectively). Carotid BF was significantly below preocclusion values by 2.5 min (p &lt; 0.05), whereas RCA velocity time integral per minute remained above preocclusion values for 9 min. CBF decreased from 316 (24) before cord occlusion to 156 (30) mL/min/100 g at 5 min (p &lt; 0.01), whereas right myocardial BF was maintained at 792 (125) and 751 (183) mL/min/100 g, respectively. CBF decreased rapidly after total cord occlusion whereas myocardial BF increased and was maintained until shortly before cardiac arrest, suggesting the myocardium to be better preserved during this type of insult in already partially asphyxiated fetuses.},
  author       = {Ley, David and Oskarsson, G and Bellander, M and Hernandez-Andrade, Edgar and Lingman, Göran and Marsal, Karel and Olsson, T and Pesonen, Erkki and Thorngren-Jerneck, Kristina and Werner, Olof and Hellström-Westas, Lena},
  issn         = {1530-0447},
  language     = {eng},
  number       = {4},
  pages        = {568--575},
  publisher    = {International Pediatric Foundation Inc.},
  series       = {Pediatric Research},
  title        = {Different responses of myocardial and cerebral blood flow to cord occlusion in exteriorized fetal sheep},
  url          = {http://dx.doi.org/10.1203/01.PDR.0000113785.66455.E7},
  volume       = {55},
  year         = {2004},
}