Publications by authors named "Karyn A Rodgers"
Article Synopsis
- Infants with congenital diaphragmatic hernia often face serious breathing issues, but a technique called physiologically based cord clamping (PBCC) can help improve blood flow to their lungs when performed before cutting the umbilical cord.
- In a study involving lambs with surgically induced diaphragmatic hernia, PBCC was tested against immediate cord clamping to see its effects on lung function over an 8-hour period following birth.
- Results showed that lambs undergoing PBCC had significantly higher pulmonary blood flow and lower pulmonary vascular resistance compared to those with immediate cord clamping, indicating that PBCC is more beneficial for lung health in this condition.
Background: Umbilical cord milking (UCM) at birth causes surges in arterial blood pressure and blood flow to the brain, which may explain the high risk of intraventricular haemorrhage (IVH) in extremely preterm infants receiving UCM. This high risk of IVH has not been reported in older infants.
Objective: We hypothesized that lung aeration before UCM, reduces the surge in blood pressure and blood flow induced by UCM.
Iatrogenic preterm premature rupture of the fetal membranes (iPPROM) remains the Achilles' heel of keyhole fetal surgery (fetoscopy) despite significant efforts in preclinical models to develop new therapies. This limited success is partially due to incomplete understanding why the fetal membranes rupture early after fetoscopy and notable differences in membrane physiology between humans and domestic species. In this review, we summarize aspects of fetoscopy that may contribute to iPPROM, the previous efforts to develop new therapies, and limitations of preclinical models commonly used in fetal membrane research.
View Article and Find Full Text PDFHigh-CPAP Does Not Impede Cardiovascular Changes at Birth in Preterm Sheep.
Front Pediatr
January 2021
Article Synopsis
- Preterm lambs were studied to evaluate the effects of different levels of continuous positive airway pressure (CPAP) on pulmonary blood flow (PBF), cerebral blood flow (CBF), and jugular vein pressure (JVP) after birth.
- Lambs were assigned to receive low-CPAP (5 cmHO), high-CPAP (15 cmHO), or dynamic high-CPAP (decreasing from 15 to 8 cmHO) for up to 30 minutes.
- Results showed that high-CPAP significantly increased PBF without negatively impacting CBF and JVP, suggesting it can safely support preterm infants without adverse cardiovascular effects.
Physiologic-based cord clamping (PBCC) involves deferring umbilical cord clamping until after lung aeration. It is unclear if infant is at risk of becoming hypothermic during PBCC. To test if PBCC would maintain core temperature more effectively than immediate cord clamping (ICC).
View Article and Find Full Text PDFEffect of lung hypoplasia on the cardiorespiratory transition in newborn lambs.
J Appl Physiol (1985)
August 2019
Newborns with lung hypoplasia (LH) commonly have limited respiratory function and often require ventilatory assistance after birth. We aimed to characterize the cardiorespiratory transition and respiratory function in newborn lambs with LH. LH was induced by draining fetal lung liquid in utero [110-133 days (d), term = 147d, = 6].
View Article and Find Full Text PDFPhysiologically based cord clamping improves cardiopulmonary haemodynamics in lambs with a diaphragmatic hernia.
Arch Dis Child Fetal Neonatal Ed
January 2020
Objective: Lung hypoplasia associated with congenital diaphragmatic hernia (CDH) results in respiratory insufficiency and pulmonary hypertension after birth. We have investigated whether aerating the lung before removing placental support (physiologically based cord clamping (PBCC)), improves the cardiopulmonary transition in lambs with a CDH.
Methods: At ≈138 days of gestational age, 17 lambs with surgically induced left-sided diaphragmatic hernia (≈d80) were delivered via caesarean section.
Neonatal cardiopulmonary transition in an ovine model of congenital diaphragmatic hernia.
Arch Dis Child Fetal Neonatal Ed
November 2019
Objective: Infants with a congenital diaphragmatic hernia (CDH) are at high risk of developing pulmonary hypertension after birth, but little is known of their physiological transition at birth. We aimed to characterise the changes in cardiopulmonary physiology during the neonatal transition in an ovine model of CDH.
Methods: A diaphragmatic hernia (DH) was surgically created at 80 days of gestational age (dGA) in 10 fetuses, whereas controls underwent sham surgery (n=6).
Effects of tracheal occlusion on the neonatal cardiopulmonary transition in an ovine model of diaphragmatic hernia.
Arch Dis Child Fetal Neonatal Ed
November 2019
Objective: Fetoscopic endoluminal tracheal occlusion (FETO) aims to reverse pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and mitigate the associated respiratory insufficiency and pulmonary hypertension after birth. We aimed to determine whether FETO improves the cardiopulmonary transition at birth in an ovine model of CDH.
Methods: In 12 ovine fetuses with surgically induced diaphragmatic hernia (DH; 80 dGA), an endotracheal balloon was placed tracheoscopically at ≈110 dGA and removed at ≈131 dGA (DH+FETO), while 10 were left untreated (DH).