The Role of Catecholamines in Lung Liquid Absorption at Birth

Walters, D. V.; Olver, R. E.

doi:10.1203/00006450-197803000-00017

Cited by 310 publications

(192 citation statements)

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“…Walters and Olver 19 demonstrated that both epinephrine and isoproterenol, but not norepinephrine, infused intravenously into chronically catheterized mature fetal sheep, caused rapid absorption of lung liquid that could be inhibited by previous treatment with propranolol. Moreover, the effect of epinephrine on fetal lung fluid secretion was further studied by Lawson et al,20 who demonstrated that epinephrine infused into fetal sheep resulted in a decrease in tracheal flow.…”

Section: Lung Fluid During and Immediately After Birthmentioning

confidence: 99%

“…21 Subsequent studies demonstrated that intraluminal administration of amiloride, a Na þ -transport inhibitor, blocked the effect of epinephrine on absorption of lung fluid, indicating that the lung liquid absorption is dependent on epinephrine-evoked Na þ transport. 19,22 At birth, the lungs must clear their fluid rapidly to enable a normal transition from intrauterine liquid breathing to postnatal air breathing. To do so, the lung has to convert quickly and efficiently from a fluid secreting to a fluid-absorbing organ.…”

Section: Lung Fluid During and Immediately After Birthmentioning

confidence: 99%

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Clinical implication of lung fluid balance in the perinatal period

2011

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At birth, lung fluid produced during fetal life must be cleared immediately and efficiently before the first breath takes place, in order for infants to achieve a normal and successful transition from prenatal to postnatal life. Postnatal lung fluid resorption is mediated through activation of airway epithelial sodium channels (ENaC). The observation that ENaC expression is a gestational age-dependent process contributes to our understanding of the development of respiratory distress in both term and preterm infants due to impaired clearing of fluid from their lungs. As fluid absorption, mediated by ENaC activity, in postnatal life has a significant biological role in preventing respiratory distress, any strategy that enhances ENaC activity can potentially help to decrease its incidence and associated morbidity.

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Section: Lung Fluid During and Immediately After Birthmentioning

confidence: 99%

Section: Lung Fluid During and Immediately After Birthmentioning

confidence: 99%

Clinical implication of lung fluid balance in the perinatal period

2011

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“…26 In a sheep model, infusion of epinephrine, a catecholamine hormone, decreased secretion and promoted the absorption of fetal lung fluid. [27][28][29][30] Despite substantial evidence linking catecholamine hormones with TTN, no prior study in humans has examined the use of exogenous catecholamines for the treatment of TTN. Epinephrine is a catecholamine hormone available in systemic and inhaled form.…”

Section: Introductionmentioning

confidence: 99%

Inhaled epinephrine for the treatment of transient tachypnea of the newborn

et al. 2008

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Objective: Infants with transient tachypnea of the newborn (TTN) have relatively low levels of epinephrine, which is known to mediate fetal lung fluid absorption. Providing exogenous epinephrine could be a valuable diagnostic and therapeutic intervention for this common condition. Our primary objective was to determine if inhaled racemic epinephrine is safe for the treatment of TTN. Our secondary objective was to determine its efficacy.Study Design: We conducted a randomized, blinded, placebo-controlled pilot trial. Inhaled racemic epinephrine or placebo was administered to 20 newborns with TTN. Physiologic variables of cardiopulmonary function were measured during and after treatment.Result: No infant in either the treatment or control arm experienced an adverse event, including tachycardia or hypertension. We did not detect a difference between the two groups regarding rate of resolution of tachypnea. Conclusion:We did not observe any adverse effects of inhaled racemic epinephrine when administered for the treatment of TTN. Larger studies are necessary to determine efficacy.

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“…The experimental procedure was similar to those described by Normand et al (1970) and Walters & Olver (1978). By following the changes in the indicator concentration, after a 30 min mixing period, the rate of lung liquid production or absorption can be calculated.…”

Section: Lung Liquid Volume Estimation Techniquementioning

confidence: 99%

“…Preparation of the fetuses was similar to that described by Walters & Olver (1978) and Brown et al (1983). Briefly, pregnant ewes (Suffolk-Clun Forest cross) were operated on between 118 and 125 days from conception (term, 147 days).…”

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confidence: 99%

The Effects of in Vivo Pulmonary Oxygenation on Lung Liquid Production in Near‐Term Fetal Sheep

Round

Junor

Gallagher

et al. 1999

Experimental Physiology

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SUMMARY Lung liquid (LL) is secreted into the fetal lung lumen, but it must be rapidly absorbed at birth to allow air breathing. In vitro studies have implicated oxygen as a possible factor causing the switch from secretion to absorption of lung liquid at birth. We developed a technique of oxygenating the fetal lung using liquid ventilation with haemoglobin (Hb) solutions in chronically catheterized fetal lambs (129‐140 days gestation; term, 147 days). In some experiments 2,3‐diphosphoglycerate (DPG) was added to increase oxygen delivery. LL secretion rate (Jv) was measured using an indicator dilution method. Eighteen fetuses were divided into four groups and ventilated with liquid under the following conditions: (i) Hb with oxygen, (ii) Hb without oxygen, (iii) Hb with DPG and oxygen and (iv) Hb with DPG without oxygen. There was a significant rise (2·6 mmHg, P < 0·02) in fetal arterial PO2 in group iii, but in none of the other groups. In the first 3 h of liquid ventilation there was no difference in Jv between the groups. In group i, during hours 4‐6 of liquid ventilation, there was a significant rise in secretion rate from 2·25 ± 0·88 to 3·74 ± 0·85 ml h−1 kg−1 (P < 0·001). In group iii, when comparing Jv in the first 3 h of liquid ventilation with that in the following 3 h period of liquid ventilation, a strong trend towards reduction in secretion was observed, falling from 3·03 ± 0·65 to 0·74 ± 0·92 ml h−1 kg−1 (three of the four experiments showed a significant decrease in Jv in hours 4‐6). These experiments indicate that oxygen delivered to the fetus using liquid ventilation with haemoglobin solutions leads to increased LL secretion when oxygen delivery is small, and suggest there is a decrease in secretion with greater oxygen delivery to the lung.

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The Role of Catecholamines in Lung Liquid Absorption at Birth

Cited by 310 publications

References 0 publications

Clinical implication of lung fluid balance in the perinatal period

Clinical implication of lung fluid balance in the perinatal period

Inhaled epinephrine for the treatment of transient tachypnea of the newborn

The Effects of in Vivo Pulmonary Oxygenation on Lung Liquid Production in Near‐Term Fetal Sheep

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