ArticleJournal of applied physiology (Bethesda, Md. : 1985)2011
Pulmonary hemodynamics and vascular reactivity in asphyxiated term lambs resuscitated with 21 and 100% oxygen.
Article in Journal of applied physiology (Bethesda, Md. : 1985), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- RECOVER Guidelines: Newborn Resuscitation in Dogs and Cats. Clinical Guidelines.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2025Guideline
- RECOVER Guidelines: Newborn Resuscitation in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2025Pooled it
- Cardiac and cerebral hemodynamics with umbilical cord milking compared with early cord clamping: A randomized cluster crossover trial.Early human development · 2023Trial
- Trial
- Mechanical Ventilation After Bidirectional Superior Cavopulmonary Anastomosis for Single-Ventricle Physiology: A Comparison of Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist.Pediatric cardiology · 2016Trial
- Tracheal suctioning improves gas exchange but not hemodynamics in asphyxiated lambs with meconium aspiration.Pediatric research · 2015Trial
- Management of Hypoxemic Respiratory Failure in the Newborn During Therapeutic Hypothermia.Clinics in perinatology · 2026Review
- Review
- Physiology-guided vasoactive therapy in neonates: rethinking dopamine as first-line.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Oxygen saturation targets in neonatal care: A narrative review.Early human development · 2024Review
- Oxygen Targets in Neonatal Pulmonary Hypertension: Individualized, "Precision-Medicine" Approach.Clinics in perinatology · 2024Review
- Physiology of neonatal resuscitation: Giant strides with small breaths.Seminars in perinatology · 2022Review
- Pulmonary hypertension in the newborn- etiology and pathogenesis.Seminars in fetal & neonatal medicine · 2022Review
- Pulmonary hypertension and oxidative stress: Where is the link?Seminars in fetal & neonatal medicine · 2022Review
- Treatments and therapeutic protocols for the recovery of an asphyxiated new-born: A review of pre-clinical and clinical studies in human neonates and in different animal models.Veterinarni medicina · 2022Review
- Factors to Consider to Study Preductal Oxygen Saturation Targets in Neonatal Pulmonary Hypertension.Children (Basel, Switzerland) · 2022Review
- Inadequate Bioavailability of Intramuscular Epinephrine in a Neonatal Asphyxia Model.Frontiers in pediatrics · 2022Article
- Neonatal chest compressions: time to act.Pediatric research · 2021Article
- Pathophysiology and Management of Persistent Pulmonary Hypertension of the Newborn.Clinics in perinatology · 2021Review
- When to say no to inhaled nitric oxide in neonates?Seminars in fetal & neonatal medicine · 2021Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
An increase in oxygen tension is an important factor in decreasing pulmonary vascular resistance (PVR) at birth. Birth asphyxia results in acidosis and increased PVR. We determined the effect of resuscitation with 21 vs. 100% O(2) on pulmonary hemodynamics, pulmonary arterial (PA) reactivity, and oxidant stress in a lamb model of in utero asphyxia. Term fetal lambs were acutely asphyxiated by intrauterine umbilical cord occlusion for 10 min resulting in acidosis (pH 6.96 ± 0.05 and Pco(2) 103 ± 5 Torr), bradycardia, systemic hypotension, and increased PVR. Lambs were treated with 30 min of resuscitation with 21% or 100% O(2) (n = 6 each). Pa(O(2)) was significantly elevated with 100% O(2) resuscitation compared with 21% O(2) (430 ± 38 vs. 64 ± 8 Torr), but changes in pH and Pa(CO(2)) were similar. The 100% O(2) induced greater increase in pulmonary blood flow and decrease in PVR at 1 min of life, but subsequent values were similar to 21% O(2) group between 2 and 30 min of life. Oxygen uptake from the lung and systemic oxygen extraction was similar between the two groups. Pulmonary arteries showed increased staining for superoxide anions and increased contractility to norepinephrine following resuscitation with 100% O(2). The increased PA contractility induced by 100% O(2) was reversed by scavenging superoxide anions with superoxide dismutase and catalase. We conclude that resuscitation of asphyxiated lambs with 100% O(2) increases Pa(O(2)) but does not improve lung oxygen uptake, decrease PVR at 30 min, or increase systemic oxygen extraction ratios. Furthermore, 100% O(2) also induces oxidative stress and increases PA contractility. These findings support the new neonatal resuscitation guidelines recommending 21% O(2) for initial resuscitation of asphyxiated neonates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.