ArticleAmerican journal of physiology. Lung cellular and molecular physiology2011
Positive end-expiratory pressure and surfactant decrease lung injury during initiation of ventilation in fetal sheep.
Article in American journal of physiology. Lung cellular and molecular physiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 51 citations in OpenAlex.
- Premature Infants Show Consistently Good Lung Compliance During Conventional Mechanical Ventilation.Pediatric pulmonology · 2025Article
- Preterm lung and brain responses to mechanical ventilation and corticosteroids.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Inflating or Overinflation? New Evidence for Lung Injury at Birth.American journal of respiratory and critical care medicine · 2023Article
- Surfactant plus budesonide decreases lung and systemic responses to injurious ventilation in preterm sheep.American journal of physiology. Lung cellular and molecular physiology · 2020Article
- Gestational Age Influences the Early Microarchitectural Changes in Response to Mechanical Ventilation in the Preterm Lamb Lung.Frontiers in pediatrics · 2019Article
- Can We Understand the Pathobiology of Bronchopulmonary Dysplasia?The Journal of pediatrics · 2017Review
- Emerging concepts in smooth muscle contributions to airway structure and function: implications for health and disease.American journal of physiology. Lung cellular and molecular physiology · 2016Review
- Brief mechanical ventilation causes differential epithelial repair along the airways of fetal, preterm lambs.American journal of physiology. Lung cellular and molecular physiology · 2016Article
- Effectiveness of Synchronized Noninvasive Ventilation to Prevent Intubation in Preterm Infants.AJP reports · 2016Article
- Selection of Reference Genes for Gene Expression Studies related to lung injury in a preterm lamb model.Scientific reports · 2016Article
- Distending Pressure Did Not Activate Acute Phase or Inflammatory Responses in the Airways and Lungs of Fetal, Preterm Lambs.PloS one · 2016Article
- Animal Models, Learning Lessons to Prevent and Treat Neonatal Chronic Lung Disease.Frontiers in medicine · 2015Review
- Unraveling the Links Between the Initiation of Ventilation and Brain Injury in Preterm Infants.Frontiers in pediatrics · 2015Review
- The role of surfactant and non-invasive mechanical ventilation in early management of respiratory distress syndrome in premature infants.World journal of pediatrics : WJP · 2014Review
- Sustained inflation at birth did not alter lung injury from mechanical ventilation in surfactant-treated fetal lambs.PloS one · 2014Article
- Protective ventilation of preterm lambs exposed to acute chorioamnionitis does not reduce ventilation-induced lung or brain injury.PloS one · 2014Article
- Airway smooth muscle in airway reactivity and remodeling: what have we learned?American journal of physiology. Lung cellular and molecular physiology · 2013Review
- Sustained inflation at birth did not protect preterm fetal sheep from lung injury.American journal of physiology. Lung cellular and molecular physiology · 2013Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
The initiation of ventilation in preterm, surfactant-deficient sheep without positive end-expiratory pressure (PEEP) causes airway injury and lung inflammation. We hypothesized that PEEP and surfactant treatment would decrease the lung injury from initiation of ventilation with high tidal volumes. Fetal sheep at 128-day gestational age were randomized to ventilation with: 1) no PEEP, no surfactant; 2) 8-cmH(2)O PEEP, no surfactant; 3) no PEEP + surfactant; 4) 8-cmH(2)O PEEP + surfactant; or 5) control (2-cmH(2)O continuous positive airway pressure) (n = 6-7/group). After maternal anesthesia and hysterotomy, the head and chest were exteriorized, and the fetus was intubated. While maintaining placental circulation, the fetus was ventilated for 15 min with a tidal volume escalating to 15 ml/kg using heated, humidified, 100% nitrogen. The fetus then was returned to the uterus, and tissue was collected after 30 min for evaluation of early markers of lung injury. Lambs receiving both surfactant and PEEP had increased dynamic compliance, increased static lung volumes, and decreased total protein and heat shock proteins 70 and 60 in bronchoalveolar lavage fluid compared with other groups. Ventilation, independent of PEEP or surfactant, increased mRNA expression of acute phase response genes and proinflammatory cytokine mRNA in the lung tissue compared with controls. PEEP decreased mRNA for cytokines (2-fold) compared with groups receiving no PEEP. Surfactant administration further decreased some cytokine mRNAs and changed the distribution of early growth response protein-1 expression. The use of PEEP during initiation of ventilation at birth decreased early mediators of lung injury. Surfactant administration changed the distribution of injury and had a moderate additive protective effect.
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Registered trials
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