Ventilation/perfusion mismatch during lung aeration at birth

Justin Lang, James Todd Pearson, Arjan B Te Pas, Megan Jane Wallace, Melissa Li-Lian Siew, Marcus John Kitchen, Andreas Fouras, Robert Lewis, Kevin Wheeler, Graeme Polglase, Mikiyasu Shirai, Takashi Sonobe, Stuart Brian Hooper

Research output: Contribution to journalArticleResearchpeer-review

Abstract

At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 +/- 11.6 and 70.3 +/- 7.5 .s to 136.3 +/- 22.6 and 136.3 +/- 23.7 .s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.
Original languageEnglish
Pages (from-to)535 - 543
Number of pages9
JournalJournal of Applied Physiology
Volume117
Issue number5
DOIs
Publication statusPublished - 2014

Cite this

Lang, Justin ; Pearson, James Todd ; Te Pas, Arjan B ; Wallace, Megan Jane ; Siew, Melissa Li-Lian ; Kitchen, Marcus John ; Fouras, Andreas ; Lewis, Robert ; Wheeler, Kevin ; Polglase, Graeme ; Shirai, Mikiyasu ; Sonobe, Takashi ; Hooper, Stuart Brian. / Ventilation/perfusion mismatch during lung aeration at birth. In: Journal of Applied Physiology. 2014 ; Vol. 117, No. 5. pp. 535 - 543.
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abstract = "At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 +/- 11.6 and 70.3 +/- 7.5 .s to 136.3 +/- 22.6 and 136.3 +/- 23.7 .s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.",
author = "Justin Lang and Pearson, {James Todd} and {Te Pas}, {Arjan B} and Wallace, {Megan Jane} and Siew, {Melissa Li-Lian} and Kitchen, {Marcus John} and Andreas Fouras and Robert Lewis and Kevin Wheeler and Graeme Polglase and Mikiyasu Shirai and Takashi Sonobe and Hooper, {Stuart Brian}",
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pages = "535 -- 543",
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Ventilation/perfusion mismatch during lung aeration at birth. / Lang, Justin; Pearson, James Todd; Te Pas, Arjan B; Wallace, Megan Jane; Siew, Melissa Li-Lian; Kitchen, Marcus John; Fouras, Andreas; Lewis, Robert; Wheeler, Kevin; Polglase, Graeme; Shirai, Mikiyasu; Sonobe, Takashi; Hooper, Stuart Brian.

In: Journal of Applied Physiology, Vol. 117, No. 5, 2014, p. 535 - 543.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Ventilation/perfusion mismatch during lung aeration at birth

AU - Lang, Justin

AU - Pearson, James Todd

AU - Te Pas, Arjan B

AU - Wallace, Megan Jane

AU - Siew, Melissa Li-Lian

AU - Kitchen, Marcus John

AU - Fouras, Andreas

AU - Lewis, Robert

AU - Wheeler, Kevin

AU - Polglase, Graeme

AU - Shirai, Mikiyasu

AU - Sonobe, Takashi

AU - Hooper, Stuart Brian

PY - 2014

Y1 - 2014

N2 - At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 +/- 11.6 and 70.3 +/- 7.5 .s to 136.3 +/- 22.6 and 136.3 +/- 23.7 .s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.

AB - At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 +/- 11.6 and 70.3 +/- 7.5 .s to 136.3 +/- 22.6 and 136.3 +/- 23.7 .s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.

UR - http://jap.physiology.org/content/117/5/535.full.pdf

U2 - 10.1152/japplphysiol.01358.2013

DO - 10.1152/japplphysiol.01358.2013

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SP - 535

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JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

SN - 8750-7587

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