Lung hypoplasia in newborn rabbits with a diaphragmatic hernia affects pulmonary ventilation but not perfusion

Andreas W. Flemmer, Marta Thio, Megan J. Wallace, Katie Lee, Marcus J. Kitchen, Lauren Kerr, Charles C. Roehr, Andreas Fouras, Richard Carnibella, Jaccques C. Jani, Philip Dekoninck, Arjan B. Te Pas, James T. Pearson, Stuart B. Hooper

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BackgroundA congenital diaphragmatic hernia (DH) can result in severe lung hypoplasia that increases the risk of morbidity and mortality after birth; however, little is known about the cardiorespiratory transition at birth.MethodsUsing phase-contrast X-ray imaging and angiography, we examined the cardiorespiratory transition at birth in rabbit kittens with DHs. Surgery was performed on pregnant New Zealand white rabbits (n=18) at 25 days' gestation to induce a left-sided DH. Kittens were delivered at 30 days' gestation, intubated, and ventilated to achieve a tidal volume (V t) of 8 ml/kg in control and 4 ml/kg in DH kittens while they were imaged.ResultsFunctional residual capacity (FRC) recruitment and V t in the hypoplastic left lung were markedly reduced, resulting in a disproportionate distribution of FRC into the right lung. Following lung aeration, relative pulmonary blood flow (PBF) increased equally in both lungs, and the increase in pulmonary venous return was similar in both control and DH kittens.ConclusionThese findings indicate that nonuniform lung hypoplasia caused by DH alters the distribution of ventilation away from hypoplastic and into normally grown lung regions. During transition, the increase in PBF and pulmonary venous return, which is vital for maintaining cardiac output, is not affected by lung hypoplasia.

Original languageEnglish
Pages (from-to)536-543
Number of pages8
JournalPediatric Research
Volume82
Issue number3
DOIs
Publication statusPublished - 1 Sep 2017

Cite this

Flemmer, Andreas W. ; Thio, Marta ; Wallace, Megan J. ; Lee, Katie ; Kitchen, Marcus J. ; Kerr, Lauren ; Roehr, Charles C. ; Fouras, Andreas ; Carnibella, Richard ; Jani, Jaccques C. ; Dekoninck, Philip ; Te Pas, Arjan B. ; Pearson, James T. ; Hooper, Stuart B. / Lung hypoplasia in newborn rabbits with a diaphragmatic hernia affects pulmonary ventilation but not perfusion. In: Pediatric Research. 2017 ; Vol. 82, No. 3. pp. 536-543.
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abstract = "BackgroundA congenital diaphragmatic hernia (DH) can result in severe lung hypoplasia that increases the risk of morbidity and mortality after birth; however, little is known about the cardiorespiratory transition at birth.MethodsUsing phase-contrast X-ray imaging and angiography, we examined the cardiorespiratory transition at birth in rabbit kittens with DHs. Surgery was performed on pregnant New Zealand white rabbits (n=18) at 25 days' gestation to induce a left-sided DH. Kittens were delivered at 30 days' gestation, intubated, and ventilated to achieve a tidal volume (V t) of 8 ml/kg in control and 4 ml/kg in DH kittens while they were imaged.ResultsFunctional residual capacity (FRC) recruitment and V t in the hypoplastic left lung were markedly reduced, resulting in a disproportionate distribution of FRC into the right lung. Following lung aeration, relative pulmonary blood flow (PBF) increased equally in both lungs, and the increase in pulmonary venous return was similar in both control and DH kittens.ConclusionThese findings indicate that nonuniform lung hypoplasia caused by DH alters the distribution of ventilation away from hypoplastic and into normally grown lung regions. During transition, the increase in PBF and pulmonary venous return, which is vital for maintaining cardiac output, is not affected by lung hypoplasia.",
author = "Flemmer, {Andreas W.} and Marta Thio and Wallace, {Megan J.} and Katie Lee and Kitchen, {Marcus J.} and Lauren Kerr and Roehr, {Charles C.} and Andreas Fouras and Richard Carnibella and Jani, {Jaccques C.} and Philip Dekoninck and {Te Pas}, {Arjan B.} and Pearson, {James T.} and Hooper, {Stuart B.}",
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Lung hypoplasia in newborn rabbits with a diaphragmatic hernia affects pulmonary ventilation but not perfusion. / Flemmer, Andreas W.; Thio, Marta; Wallace, Megan J.; Lee, Katie; Kitchen, Marcus J.; Kerr, Lauren; Roehr, Charles C.; Fouras, Andreas; Carnibella, Richard; Jani, Jaccques C.; Dekoninck, Philip; Te Pas, Arjan B.; Pearson, James T.; Hooper, Stuart B.

In: Pediatric Research, Vol. 82, No. 3, 01.09.2017, p. 536-543.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Lung hypoplasia in newborn rabbits with a diaphragmatic hernia affects pulmonary ventilation but not perfusion

AU - Flemmer, Andreas W.

AU - Thio, Marta

AU - Wallace, Megan J.

AU - Lee, Katie

AU - Kitchen, Marcus J.

AU - Kerr, Lauren

AU - Roehr, Charles C.

AU - Fouras, Andreas

AU - Carnibella, Richard

AU - Jani, Jaccques C.

AU - Dekoninck, Philip

AU - Te Pas, Arjan B.

AU - Pearson, James T.

AU - Hooper, Stuart B.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - BackgroundA congenital diaphragmatic hernia (DH) can result in severe lung hypoplasia that increases the risk of morbidity and mortality after birth; however, little is known about the cardiorespiratory transition at birth.MethodsUsing phase-contrast X-ray imaging and angiography, we examined the cardiorespiratory transition at birth in rabbit kittens with DHs. Surgery was performed on pregnant New Zealand white rabbits (n=18) at 25 days' gestation to induce a left-sided DH. Kittens were delivered at 30 days' gestation, intubated, and ventilated to achieve a tidal volume (V t) of 8 ml/kg in control and 4 ml/kg in DH kittens while they were imaged.ResultsFunctional residual capacity (FRC) recruitment and V t in the hypoplastic left lung were markedly reduced, resulting in a disproportionate distribution of FRC into the right lung. Following lung aeration, relative pulmonary blood flow (PBF) increased equally in both lungs, and the increase in pulmonary venous return was similar in both control and DH kittens.ConclusionThese findings indicate that nonuniform lung hypoplasia caused by DH alters the distribution of ventilation away from hypoplastic and into normally grown lung regions. During transition, the increase in PBF and pulmonary venous return, which is vital for maintaining cardiac output, is not affected by lung hypoplasia.

AB - BackgroundA congenital diaphragmatic hernia (DH) can result in severe lung hypoplasia that increases the risk of morbidity and mortality after birth; however, little is known about the cardiorespiratory transition at birth.MethodsUsing phase-contrast X-ray imaging and angiography, we examined the cardiorespiratory transition at birth in rabbit kittens with DHs. Surgery was performed on pregnant New Zealand white rabbits (n=18) at 25 days' gestation to induce a left-sided DH. Kittens were delivered at 30 days' gestation, intubated, and ventilated to achieve a tidal volume (V t) of 8 ml/kg in control and 4 ml/kg in DH kittens while they were imaged.ResultsFunctional residual capacity (FRC) recruitment and V t in the hypoplastic left lung were markedly reduced, resulting in a disproportionate distribution of FRC into the right lung. Following lung aeration, relative pulmonary blood flow (PBF) increased equally in both lungs, and the increase in pulmonary venous return was similar in both control and DH kittens.ConclusionThese findings indicate that nonuniform lung hypoplasia caused by DH alters the distribution of ventilation away from hypoplastic and into normally grown lung regions. During transition, the increase in PBF and pulmonary venous return, which is vital for maintaining cardiac output, is not affected by lung hypoplasia.

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DO - 10.1038/pr.2017.91

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EP - 543

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

IS - 3

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