Effect of Intraventricular Hemorrhage on Pulmonary Function in Newborn Piglets

Abstract

Intracranial hemorrhage in the premature infant is often associated with respiratory failure and need for mechanical ventilation. We therefore addressed the question of possible interactions with and pulmonary consequences of intraventricular hemorrhage. Newborn piglets were studied during intraventricular hemorrhage simulated by intraventricular blood infusion. Infusion volume amounted to 8% of estimated brain weight. Respiratory rate, minute ventilation, lung resistance and dynamic lung compliance, as well as arterial blood gases, arterial and intraventricular pressures were measured. The piglets were mechanically ventilated with a low basal rate of 20 breaths per minute throughout the study. All piglets experienced significant rise in intraventricular pressure and respiratory failure during the study. Respiratory failure was mainly a result of a reduction in respiratory frequency and minute ventilation until apnea. However, a rise in lung resistance was also noted while lung compliance did not change. We conclude that increased need for mechanical ventilation during intracranial hemorrhage is primarilty a consequence of hypoventilation. The increase seen in lung resistance could also suggest that intraventricular hemorrhage causes an element of bronchiolar constriction. Furthermore, these effects are not only a result of the increase in intraventricular pressure, but specific effects of blood components within the central nervous system must be considered.

Topical Review: Animal Models of Germinal Matrix Hemorrhage

“…For example, artificial intraventricular hemorrhage in newborn pigs leads to suppressed respiration at least in part through elevated intracranial pressure. 55 Systemic vascular reactivity is impaired in this model. 56,57…”

Relevance of Porcine Stroke Models to Bridge the Gap from Pre-Clinical Findings to Clinical Implementation

“…ICH was first modeled in pigs by Farstad et al in 1994. In this study, they injected autologous blood in the lateral ventricles of neonatal piglets [ 230 ]. An analogous technique was used in juvenile pigs in 1997 [ 195 ], but intraventricular hemorrhage models remain rarely used.…”

Opportunities in posthemorrhagic hydrocephalus research: outcomes of the Hydrocephalus Association Posthemorrhagic Hydrocephalus Workshop

“…There is a wide range of animal models used for research in PHH of prematurity and germinal matrix hemorrhage (reviewed in [ 233 , 234 ]), and no single animal model will be suitable for all biological questions. Most studies involve experimental induction of IVH in mice [ 67 , 191 , 235 ], rats [ 182 , 185 , 202 , 236 – 243 ], rabbits [ 244 – 250 ], cats [ 251 ], dogs [ 252 , 253 ], sheep [ 254 ], and pigs [ 255 – 258 ]. While the majority of these in vivo studies have employed intraventricular injection of whole blood or blood products, others have used alternative approaches [ 67 , 247 , 259 – 261 ].…”