Abstract
Antenatal glucocorticoids, exogenous surfactant, and positive end-expiratory pressure (PEEP) ventilation are commonly provided to preterm infants to enhance respiratory function after birth. It is unclear how these treatments interact to improve the transition to air-breathing at birth. We investigated the relative contribution of antenatal betamethasone, prophylactic surfactant, and PEEP (3 cmH2O) on functional residual capacity (FRC) and dynamic lung compliance (CDL) in preterm (28 day GA) rabbit kittens at birth. Kittens were delivered by cesarean section and mechanically ventilated. FRC was calculated from X-ray images, and CDL was measured using plethysmography. Without betamethasone, PEEP increased FRC recruitment and CDL. Surfactant did not further increase FRC, but significantly increased CDL. Betamethasone abolished the benefit of PEEP on FRC, but surfactant counteracted this effect of betamethasone. These findings indicate that low PEEP levels are insufficient to establish FRC at birth following betamethasone treatment. However, surfactant reversed the effect of betamethasone and when combined, these two treatments enhanced FRC recruitment irrespective of PEEP level.
| Original language | English |
|---|---|
| Pages (from-to) | 750-759 |
| Number of pages | 10 |
| Journal | Journal of Applied Physiology |
| Volume | 121 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1 Sep 2016 |
Keywords
- Betamethasone
- Functional residual capacity
- Positive end-expiratory pressure
- Preterm birth
- Surfactant
Cite this
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Effect of betamethasone, surfactant, and positive end-expiratory pressures on lung aeration at birth in preterm rabbits. / Crawshaw, Jessica Rose; Hooper, Stuart; Te Pas, Arjan; Allison, Beth; Wallace, Megan; Kerr, Lauren; Lewis, Rob; Morley, Colin; Leong, Andrew; Kitchen, Marcus.
In: Journal of Applied Physiology, Vol. 121, No. 3, 01.09.2016, p. 750-759.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Effect of betamethasone, surfactant, and positive end-expiratory pressures on lung aeration at birth in preterm rabbits
AU - Crawshaw, Jessica Rose
AU - Hooper, Stuart
AU - Te Pas, Arjan
AU - Allison, Beth
AU - Wallace, Megan
AU - Kerr, Lauren
AU - Lewis, Rob
AU - Morley, Colin
AU - Leong, Andrew
AU - Kitchen, Marcus
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Antenatal glucocorticoids, exogenous surfactant, and positive end-expiratory pressure (PEEP) ventilation are commonly provided to preterm infants to enhance respiratory function after birth. It is unclear how these treatments interact to improve the transition to air-breathing at birth. We investigated the relative contribution of antenatal betamethasone, prophylactic surfactant, and PEEP (3 cmH2O) on functional residual capacity (FRC) and dynamic lung compliance (CDL) in preterm (28 day GA) rabbit kittens at birth. Kittens were delivered by cesarean section and mechanically ventilated. FRC was calculated from X-ray images, and CDL was measured using plethysmography. Without betamethasone, PEEP increased FRC recruitment and CDL. Surfactant did not further increase FRC, but significantly increased CDL. Betamethasone abolished the benefit of PEEP on FRC, but surfactant counteracted this effect of betamethasone. These findings indicate that low PEEP levels are insufficient to establish FRC at birth following betamethasone treatment. However, surfactant reversed the effect of betamethasone and when combined, these two treatments enhanced FRC recruitment irrespective of PEEP level.
AB - Antenatal glucocorticoids, exogenous surfactant, and positive end-expiratory pressure (PEEP) ventilation are commonly provided to preterm infants to enhance respiratory function after birth. It is unclear how these treatments interact to improve the transition to air-breathing at birth. We investigated the relative contribution of antenatal betamethasone, prophylactic surfactant, and PEEP (3 cmH2O) on functional residual capacity (FRC) and dynamic lung compliance (CDL) in preterm (28 day GA) rabbit kittens at birth. Kittens were delivered by cesarean section and mechanically ventilated. FRC was calculated from X-ray images, and CDL was measured using plethysmography. Without betamethasone, PEEP increased FRC recruitment and CDL. Surfactant did not further increase FRC, but significantly increased CDL. Betamethasone abolished the benefit of PEEP on FRC, but surfactant counteracted this effect of betamethasone. These findings indicate that low PEEP levels are insufficient to establish FRC at birth following betamethasone treatment. However, surfactant reversed the effect of betamethasone and when combined, these two treatments enhanced FRC recruitment irrespective of PEEP level.
KW - Betamethasone
KW - Functional residual capacity
KW - Positive end-expiratory pressure
KW - Preterm birth
KW - Surfactant
UR - http://www.scopus.com/inward/record.url?scp=84988908291&partnerID=8YFLogxK
U2 - 10.1152/japplphysiol.01043.2015
DO - 10.1152/japplphysiol.01043.2015
M3 - Article
VL - 121
SP - 750
EP - 759
JO - Journal of Applied Physiology
JF - Journal of Applied Physiology
SN - 8750-7587
IS - 3
ER -