High-frequency Oscillatory Ventilation

Yoder, Bradley A.; Siler-Khodr, Theresa M.; Winter, Vicki T.; Coalson, Jacqueline J.

doi:10.1164/ajrccm.162.5.9912145

Cited by 158 publications

(25 citation statements)

References 60 publications

(71 reference statements)

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“…Clinical interest in noninvasive HFOV stems from the fact that it does not require synchronization with the patient's breathing efforts [5]. In addition, HFOV is effective in eliminating CO 2 [6,7,21] while inducing less lung injury [3] and ensuring better alveolar development [8]. …”

Section: Discussionmentioning

confidence: 99%

“…First, it is well established that endotracheal HFOV is associated with less lung injury than conventional mechanical ventilation in animal studies [3], as well as with superior lung function at 11-14 years of age in extremely prematurely born children [4]. Secondly, nHFOV does not require synchronization with the patient's respiratory efforts, a strong advantage in the newborn [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laryngeal Muscle Activity during Nasal High-Frequency Oscillatory Ventilation in Nonsedated Newborn Lambs

et al. 2015

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Background: We have previously shown that nasal pressure support ventilation (nPSV) can lead to an active inspiratory laryngeal narrowing in lambs. This, in turn, can limit lung ventilation and divert air into the digestive system, with potentially deleterious consequences. On the other hand, nasal high-frequency oscillatory ventilation (nHFOV) is particularly attractive in newborns, especially since, unlike nPSV, it does not require synchronization with the patient's inspiratory efforts. Objectives: The main aim of the present study was to test the hypothesis that glottal constrictor muscle activity (EMG) does not develop during nHFOV. A secondary objective was to study laryngeal EMG during nHFOV-induced central apneas. Methods: Polysomnographic recordings were performed in 7 nonsedated lambs which were ventilated with increasing levels of nPSV and nHFOV at both 4 and 8 Hz, in random order. States of alertness, diaphragm and glottal muscle EMG, SpO₂, and respiratory movements were continuously recorded. Results: While phasic inspiratory glottal constrictor EMG appeared with increasing nPSV levels in 6 out of 7 lambs, it was never observed with nHFOV. In addition, nHFOV at 4 Hz dramatically inhibited central respiratory drive in 4/7 lambs, with 64-100% of recording time spent in central apnea in 3 lambs. No glottal constrictor EMG was observed during these central apneas. Conclusion: nHFOV does not induce glottal constrictor muscle EMG in nonsedated newborn lambs, in contrast to nPSV. This may be an additional advantage of nHFOV relative to nPSV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laryngeal Muscle Activity during Nasal High-Frequency Oscillatory Ventilation in Nonsedated Newborn Lambs

et al. 2015

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“…The management, monitoring and treatment strategies of all baboon infants in this analysis have been described in detail in previous publications (35–38). The management of all groups of preterm baboons was initially identical.…”

Section: Methodsmentioning

confidence: 99%

MR imaging correlates of white-matter pathology in a preterm baboon model

et al. 2011

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ArticlesTranslational Investigation nature publishing group INTRODUCTION: cerebral white-matter (WM) abnormalities on magnetic resonance imaging (MRI) correlate with neurodevelopmental disability in infants born prematurely. RESULTS: Quantitative histological measures of WM and ventricular volumes correlated with qualitative MRI scores of WM volume loss and ventriculomegaly. Diffuse astrocytosis was associated with signal abnormality on T 2 -weighted imaging and higher apparent diffusion coefficient in WM. Loss of oligodendrocytes was associated with lower relative anisotropy characterized by higher radial diffusivity values. The relationship between histopathology and MRI abnormalities was more pronounced in animals in the 28 d model, equivalent to the term human infant. DISCUSSION: MRI reflects microstructural and anatomical abnormalities that are characteristic of WM injury in the preterm brain, and these changes are more evident on MRI at term-equivalent postmenstrual age. METHODS:We assessed the histopathological correlates of MRI abnormalities in a baboon model of premature birth. Baboons were delivered at 125 d of gestation (dg, term ~185 dg) and maintained in an animal intensive care unit for 14 (n = 26) or 28 d (n = 17). Gestational control animals were delivered at 140 dg (n = 9) or 153 dg (n = 4). cerebral WM in fixed brains was evaluated using MRI, diffusion tensor imaging (DTI), and histopathology.

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“…A detailed description of the postnatal clinical and nutritional management of the preterm baboons has been previously published (39). Briefly, during the first 24 h of life, all animals received heparinized normal saline and 5% dextrose/water and supplemental calcium infusion.…”

Section: Induction Of Preterm Delivery and Postnatal Carementioning

confidence: 99%

Is nephrogenesis affected by preterm birth? Studies in a non-human primate model

Gubhaju

Sutherland

Yoder

et al. 2009

American Journal of Physiology-Renal Physiology

118

137

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Nephrogenesis occurs predominantly in late gestation at a time when preterm infants are already delivered. The aims of this study were to assess the effect of preterm birth and the effect of antenatal glucocorticoid treatment on nephrogenesis. Preterm baboons, which were delivered at 125 days gestation and ventilated for up to 21 days postnatally, were compared with gestational controls. A cohort of preterm baboons that had been exposed to antenatal glucocorticoids were compared with unexposed preterm baboons. The number of glomerular generations was estimated using a medullary ray glomerular-counting method, and glomerular number was estimated using unbiased stereology. CD31 and WT-1 localization was examined using immunohistochemistry and VEGF was localized using in situ hybridization. The number of glomerular generations was not affected by preterm birth, and total glomerular numbers were within the normal range. Kidneys were significantly enlarged in preterm baboons with a significant decrease in glomerular density (number of glomeruli per gram of kidney) in the preterm kidney compared with gestational controls. Neonates exposed to antenatal steroids had an increased kidney-to-body weight ratio and also more developed glomeruli compared with unexposed controls. Abnormal glomeruli, with a cystic Bowman's space and shrunken glomerular tuft, were often present in the superficial renal cortex of both the steroid-exposed and unexposed preterm kidneys; steroid exposure had no significant effect on the proportion of abnormal glomeruli. The proportion of abnormal glomeruli in the preterm kidneys ranged from 0.2 to 18%. In conclusion, although nephrogenesis is ongoing in the extrauterine environment, our findings demonstrate that preterm birth, independent of steroid exposure, is associated with a high proportion of abnormal glomeruli in some, but not all neonatal kidneys. Whether final nephron endowment is affected in those kidneys exhibiting a high proportion of abnormal glomeruli is yet to be confirmed.

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High-frequency Oscillatory Ventilation

Cited by 158 publications

References 60 publications

Laryngeal Muscle Activity during Nasal High-Frequency Oscillatory Ventilation in Nonsedated Newborn Lambs

Laryngeal Muscle Activity during Nasal High-Frequency Oscillatory Ventilation in Nonsedated Newborn Lambs

MR imaging correlates of white-matter pathology in a preterm baboon model

Is nephrogenesis affected by preterm birth? Studies in a non-human primate model

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