Vitamin A Protects the Preterm Lamb Diaphragm Against Adverse Effects of Mechanical Ventilation

Song, Yong; Dahl, Mar Janna; Leavitt, Wendy; Alvord, Jeremy; Bradford, Calan Y.; Albertine, Kurt H.; Pillow, J. Jane

doi:10.3389/fphys.2018.01119

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…Preterm ventilated lambs that were treated with daily enteral vitamin A exhibited decreased diaphragmatic proteolysis and oxidative injury compared to placebo-treated ventilated controls. 102 …”

Section: Factors That Impact On Respiratory Muscle Functionmentioning

confidence: 99%

Respiratory muscle function in the newborn: a narrative review

2021

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Our aim was to summarise the current evidence and methods used to assess respiratory muscle function in the newborn, focusing on current and future potential clinical applications. The respiratory muscles undertake the work of breathing and consist mainly of the diaphragm, which in the newborn is prone to dysfunction due to lower muscle mass, flattened shape and decreased content of fatigue-resistant muscle fibres. Premature infants are prone to diaphragmatic dysfunction due to limited reserves and limited capacity to generate force and avoid fatigue. Methods to assess the respiratory muscles in the newborn include electromyography, maximal respiratory pressures, assessment for thoraco-abdominal asynchrony and composite indices, such as the pressure–time product and the tension time index. Recently, there has been significant interest and a growing body of research in assessing respiratory muscle function using bedside ultrasonography. Neurally adjusted ventilator assist is a novel ventilation mode, where the level of the respiratory support is determined by the diaphragmatic electrical activity. Prolonged mechanical ventilation, hypercapnia and hypoxia, congenital anomalies and systemic or respiratory infection can negatively impact respiratory muscle function in the newborn, while caffeine and synchronised or volume-targeted ventilation have a positive effect on respiratory muscle function compared to conventional, non-triggered or pressure-limited ventilation, respectively. Impact Respiratory muscle function is impaired in prematurely born neonates and infants with congenital anomalies, such as congenital diaphragmatic hernia. Respiratory muscle function is negatively affected by prolonged ventilation and infection and positively affected by caffeine and synchronised compared to non-synchronised ventilation modes. Point-of-care diaphragmatic ultrasound and neurally adjusted ventilator assist are recent diagnostic and therapeutic technological developments with significant clinical applicability.

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Section: Factors That Impact On Respiratory Muscle Functionmentioning

confidence: 99%

Respiratory muscle function in the newborn: a narrative review

2021

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“…In animals subjected to oxidative lung injury, retinoic acid supplementation has been shown to increase mean alveolar area, improve alveolar regeneration, decrease pulmonary fibrosis, and prevent oxidative damage to the diaphragm (126)(127)(128).…”

Section: Vitamin Amentioning

confidence: 99%

Pharmacotherapy in Bronchopulmonary Dysplasia: What Is the Evidence?

Sakaria

Dhanireddy

2022

Front. Pediatr.

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Bronchopulmonary Dysplasia (BPD) is a multifactorial disease affecting over 35% of extremely preterm infants born each year. Despite the advances made in understanding the pathogenesis of this disease over the last five decades, BPD remains one of the major causes of morbidity and mortality in this population, and the incidence of the disease increases with decreasing gestational age. As inflammation is one of the key drivers in the pathogenesis, it has been targeted by majority of pharmacological and non-pharmacological methods to prevent BPD. Most extremely premature infants receive a myriad of medications during their stay in the neonatal intensive care unit in an effort to prevent or manage BPD, with corticosteroids, caffeine, and diuretics being the most commonly used medications. However, there is no consensus regarding their use and benefits in this population. This review summarizes the available literature regarding these medications and aims to provide neonatologists and neonatal providers with evidence-based recommendations.

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“…In contrast to vitamins A and D, studies on vitamin C have been restricted to calls for further studies on the utility of vitamin C supplementation during pregnancy to improve fetal lung development in smoking mothers (366,381). Studies continue to support the further study of vitamin A in lung development and BPD, including demonstration that vitamin A protects against adverse effects of mechanical ventilation on the diaphragm in preterm lambs (540), and that retinoic acid together with tracheal occlusion preserved lung epithelial cell differentiation and pulmonary vascularization (120). These observations on vitamin A and vitamin D are summarized and integrated in Fig.…”

Section: Vitaminsmentioning

confidence: 99%

Recent advances in our understanding of the mechanisms of lung alveolarization and bronchopulmonary dysplasia

Lignelli

Palumbo

Myti

et al. 2019

American Journal of Physiology-Lung Cellular and Molecular Phys

110

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Bronchopulmonary dysplasia (BPD) is the most common cause of morbidity and mortality in preterm infants. A key histopathological feature of BPD is stunted late lung development, where the process of alveolarization—the generation of alveolar gas exchange units—is impeded, through mechanisms that remain largely unclear. As such, there is interest in the clarification both of the pathomechanisms at play in affected lungs, and the mechanisms of de novo alveoli generation in healthy, developing lungs. A better understanding of normal and pathological alveolarization might reveal opportunities for improved medical management of affected infants. Furthermore, disturbances to the alveolar architecture are a key histopathological feature of several adult chronic lung diseases, including emphysema and fibrosis, and it is envisaged that knowledge about the mechanisms of alveologenesis might facilitate regeneration of healthy lung parenchyma in affected patients. To this end, recent efforts have interrogated clinical data, developed new—and refined existing—in vivo and in vitro models of BPD, have applied new microscopic and radiographic approaches, and have developed advanced cell-culture approaches, including organoid generation. Advances have also been made in the development of other methodologies, including single-cell analysis, metabolomics, lipidomics, and proteomics, as well as the generation and use of complex mouse genetics tools. The objective of this review is to present advances made in our understanding of the mechanisms of lung alveolarization and BPD over the period 1 January 2017–30 June 2019, a period that spans the 50th anniversary of the original clinical description of BPD in preterm infants.

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Vitamin A Protects the Preterm Lamb Diaphragm Against Adverse Effects of Mechanical Ventilation

Cited by 4 publications

References 42 publications

Respiratory muscle function in the newborn: a narrative review

Respiratory muscle function in the newborn: a narrative review

Pharmacotherapy in Bronchopulmonary Dysplasia: What Is the Evidence?

Recent advances in our understanding of the mechanisms of lung alveolarization and bronchopulmonary dysplasia

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