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

Peter A Dargaville, Anna Lavizzari, Priscila Padoin, Don Black, Elroy Zonneveld, Elizabeth Perkins, Magdy Sourial, Anushi Erandica Rajapaksa, Peter G Davis, Stuart Brian Hooper, Timothy James Murugesan Moss, Graeme Polglase, David Gerald Tingay

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.
Original languageEnglish
Article number13
Number of pages12
JournalIntensive Care Medicine Experimental
Volume3
DOIs
Publication statusPublished - 2015

Cite this

Dargaville, P. A., Lavizzari, A., Padoin, P., Black, D., Zonneveld, E., Perkins, E., ... Tingay, D. G. (2015). An authentic animal model of the very preterm infant on nasal continuous positive airway pressure. Intensive Care Medicine Experimental, 3, [13]. https://doi.org/10.1186/s40635-015-0051-4
Dargaville, Peter A ; Lavizzari, Anna ; Padoin, Priscila ; Black, Don ; Zonneveld, Elroy ; Perkins, Elizabeth ; Sourial, Magdy ; Rajapaksa, Anushi Erandica ; Davis, Peter G ; Hooper, Stuart Brian ; Moss, Timothy James Murugesan ; Polglase, Graeme ; Tingay, David Gerald. / An authentic animal model of the very preterm infant on nasal continuous positive airway pressure. In: Intensive Care Medicine Experimental. 2015 ; Vol. 3.
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abstract = "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.",
author = "Dargaville, {Peter A} and Anna Lavizzari and Priscila Padoin and Don Black and Elroy Zonneveld and Elizabeth Perkins and Magdy Sourial and Rajapaksa, {Anushi Erandica} and Davis, {Peter G} and Hooper, {Stuart Brian} and Moss, {Timothy James Murugesan} and Graeme Polglase and Tingay, {David Gerald}",
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language = "English",
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Dargaville, PA, Lavizzari, A, Padoin, P, Black, D, Zonneveld, E, Perkins, E, Sourial, M, Rajapaksa, AE, Davis, PG, Hooper, SB, Moss, TJM, Polglase, G & Tingay, DG 2015, 'An authentic animal model of the very preterm infant on nasal continuous positive airway pressure' Intensive Care Medicine Experimental, vol. 3, 13. https://doi.org/10.1186/s40635-015-0051-4

An authentic animal model of the very preterm infant on nasal continuous positive airway pressure. / Dargaville, Peter A; Lavizzari, Anna; Padoin, Priscila; Black, Don; Zonneveld, Elroy; Perkins, Elizabeth; Sourial, Magdy; Rajapaksa, Anushi Erandica; Davis, Peter G; Hooper, Stuart Brian; Moss, Timothy James Murugesan; Polglase, Graeme; Tingay, David Gerald.

In: Intensive Care Medicine Experimental, Vol. 3, 13, 2015.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - An authentic animal model of the very preterm infant on nasal continuous positive airway pressure

AU - Dargaville, Peter A

AU - Lavizzari, Anna

AU - Padoin, Priscila

AU - Black, Don

AU - Zonneveld, Elroy

AU - Perkins, Elizabeth

AU - Sourial, Magdy

AU - Rajapaksa, Anushi Erandica

AU - Davis, Peter G

AU - Hooper, Stuart Brian

AU - Moss, Timothy James Murugesan

AU - Polglase, Graeme

AU - Tingay, David Gerald

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512986/pdf/40635_2015_Article_51.pdf

U2 - 10.1186/s40635-015-0051-4

DO - 10.1186/s40635-015-0051-4

M3 - Article

VL - 3

JO - Intensive Care Medicine Experimental

JF - Intensive Care Medicine Experimental

SN - 2197-425X

M1 - 13

ER -