Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

Wang, Qiming; Gold, Nathan; Frasch, Martin G.; Huang, Huaxiong; Thiriet, Marc; Wang, Xiaogang

doi:10.1007/s11538-015-0122-4

Cited by 8 publications

(10 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During hypoglycemia, the glucose metabolism is primarily mediated through stress responses (endogenous hormone release of ACTH and cortisol). The heart beat variability can be considered as an end-organ specific reaction to stress [ 34 , 35 ]. Therefore, although dexamethasone injection during pregnancy is a typical procedure that induces changes in the HPAA, this study can only demonstrate an alteration of the HPAA response but not a stress axis alteration per se.…”

Section: Discussionmentioning

confidence: 99%

Effects of Late Gestational Fetal Exposure to Dexamethasone Administration on the Postnatal Hypothalamus-Pituitary-Adrenal Axis Response to Hypoglycemia in Pigs

Schiffner

Rodríguez-González²,

Rakers

et al. 2017

IJMS

View full text Add to dashboard Cite

Background: Prenatal glucocorticoid administration alters the activity of the fetal hypothalamic-pituitary-adrenocortical axis (HPAA), and correspondingly the adenocorticotropic hormone (ACTH) and cortisol levels after birth. The dosages required for these effects are critically discussed. Activation of the HPAA is related to metabolic syndrome and diabetes mellitus. Hypoglycemia is the classic side effect of antidiabetic treatment. We hypothesized that a low dosage of dexamethasone in late pregnancy alters the HPAA response to hypoglycemia in pigs. Methods: 12 pregnant sows were randomly assigned to two groups which received either a low-dose intramuscular injection (99th and 100th day of gestation) of dexamethasone (0.06 μg/kg body weight) or vehicle. Three months after birth, 18 dexamethasone-treated anaesthetized offspring and 12 control offspring underwent a 75 min hypoglycemic clamp (blood glucose below 4 mmol/L) procedure. Heart rate (HR), blood pressure, ACTH and cortisol levels and body weight (at birth and after three months) were recorded. Results: Dexamethasone-treated animals exhibited significantly elevated ACTH (139.9 ± 12.7 pg/mL) and cortisol (483.1 ± 30.3 nmol/L) levels during hypoglycemia as compared to the control group (41.7 ± 6.5 pg/mL and 257.9 ± 26.7 nmol/L, respectively), as well as an elevated HR (205.5 ± 5.7 bpm) and blood pressure (systolic: 128.6 ± 1.5, diastolic: 85.7 ± 0.7 mmHg) response as compared to the control group (153.2 ± 4.5 bpm; systolic: 118.6 ± 1.6, diastolic: 79.5 ± 1.4 mmHg, respectively; p < 0.001). Conclusions: Low-dose prenatal administration of dexamethasone not only exerts effects on the HPAA (ACTH and cortisol concentration) and vital parameters (HR and diastolic blood pressure) under baseline conditions, but also on ACTH, HR and systolic blood pressure during hypoglycemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of Late Gestational Fetal Exposure to Dexamethasone Administration on the Postnatal Hypothalamus-Pituitary-Adrenal Axis Response to Hypoglycemia in Pigs

Schiffner

Rodríguez-González²,

Rakers

et al. 2017

IJMS

View full text Add to dashboard Cite

show abstract

“…Jongen et al reduced the complexity of these models ( 52 , 66 , 67 ) to limit the number of indirect measured fetal parameters ( 70 ) and to study umbilical cord compression during contractions of the uterus ( 71 ). In addition, Wang et al ( 72 ) extended the model of ( 52 ) to simulate glucose, lactate, and pyruvate to detect fetal acidemia during labor. As far as we know, this model with all these physiological functions (hemodynamics, oxygen transport, baro- and chemoreceptor reflex, and acidemia) describes the most relevant physiological functions integrated in one model so far.…”

Section: Fetal Circulatory Modelsmentioning

confidence: 99%

A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

et al. 2022

View full text Add to dashboard Cite

BackgroundPreterm birth is the main cause of neonatal deaths with increasing mortality and morbidity rates with decreasing GA at time of birth. Currently, premature infants are treated in neonatal intensive care units to support further development. However, the organs of, especially, extremely premature infants (born before 28 weeks of GA) are not mature enough to function optimally outside the womb. This is seen as the main cause of the high morbidity and mortality rates in this group. A liquid-filled incubator, a so-called PLS system, could potentially improve these numbers for extremely premature infants, since this system is designed to mimic the environment of the natural womb. To support the development and implementation of such a complex system and to interpret vital signals of the fetus during a PLS system operation, a digital twin is proposed. This mathematical model is connected with a manikin representing the digital and physical twin of the real-life PLS system. Before developing a digital twin of a fetus in a PLS system, its functional and technical requirements are defined and existing mathematical models are evaluated.Method and resultsThis review summarizes existing 0D and 1D fetal circulatory models that potentially could be (partly) adopted for integration in a digital twin of a fetus in a PLS system based on predefined requirements. The 0D models typically describe hemodynamics and/or oxygen transport during specific events, such as the transition from fetus to neonate. Furthermore, these models can be used to find hemodynamic differences between healthy and pathological physiological states. Rather than giving a global description of an entire cardiovascular system, some studies focus on specific organs or vessels. In order to analyze pressure and flow wave profiles in the cardiovascular system, transmission line or 1D models are used. As for now, these models do not include oxygen transport.ConclusionThis study shows that none of the models identified in literature meet all the requirements relevant for a digital twin of a fetus in a PLS system. Nevertheless, it does show the potential to develop this digital twin by integrating (parts) of models into a single model.

show abstract

“…Mathematical models exist for CPS and fetal cardiovascular responses to labor, for example. [48,49] Such models could be combined and explored in silico to derive numerical predictions of HRV properties specific to fetal iHRV and their quantitative contribution to fetal cardiac function in vivo.…”

Section: ) Can the Impact Of Fetal Hypoxia Or Infection On Cps Be Camentioning

confidence: 99%

Impact of Chronic Fetal Hypoxia and Inflammation on Cardiac Pacemaker Cell Development

Frasch

Giussani

2020

Cells

Self Cite

View full text Add to dashboard Cite

Chronic fetal hypoxia and infection are examples of adverse conditions during complicated pregnancy, which impact cardiac myogenesis and increase the lifetime risk of heart disease.However, the effects that chronic hypoxic or inflammatory environments exert on cardiac pacemaker cells are poorly understood. Here, we review the current evidence and novel avenues of bench-to-bed research in this field of perinatal cardiogenesis as well as its translational significance for early detection of future risk for cardiovascular disease.

show abstract

Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

Cited by 8 publications

References 53 publications

Effects of Late Gestational Fetal Exposure to Dexamethasone Administration on the Postnatal Hypothalamus-Pituitary-Adrenal Axis Response to Hypoglycemia in Pigs

Effects of Late Gestational Fetal Exposure to Dexamethasone Administration on the Postnatal Hypothalamus-Pituitary-Adrenal Axis Response to Hypoglycemia in Pigs

A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system

Impact of Chronic Fetal Hypoxia and Inflammation on Cardiac Pacemaker Cell Development

Contact Info

Product

Resources

About