ArticlePloS one2012
Initiation of resuscitation with high tidal volumes causes cerebral hemodynamic disturbance, brain inflammation and injury in preterm lambs.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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Who cites it
61 citing papers in PubMed, 146 citations in OpenAlex.
- Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial.Trials · 2015Trial
- Trial
- From Breath to Brain: NICU respiratory interventions and bedside brain signal entropy predict later autism risk.Developmental cognitive neuroscience · 2026Article
- Volume targeted mask ventilation during simulated neonatal resuscitation - A randomized crossover manikin study.Resuscitation plus · 2025Article
- Chest Compression Superimposed with Sustained Inflation or 3:1 Compression/Ventilation Ratio During Neonatal Cardiopulmonary Resuscitation in the Delivery Room: A Systematic Review and Meta-Analysis.Children (Basel, Switzerland) · 2025Review
- Study protocol for the volume targeted mask ventilation versus pressure ventilation in preterm infants-the VOLT-trial.Frontiers in pediatrics · 2025Article
- The newborn delivery room of tomorrow: emerging and future technologies.Pediatric research · 2024Review
- Decreased Cerebral Creatine and N-Acetyl Aspartate Concentrations after Severe COVID-19 Infection: A Magnetic Resonance Spectroscopy Study.Journal of clinical medicine · 2024Article
- Comparison of positive pressure ventilation devices during compliance changes in a neonatal ovine model.Pediatric research · 2024Article
- Early administration of umbilical cord blood cells following brief high tidal volume ventilation in preterm sheep: a cautionary tale.Journal of neuroinflammation · 2024Article
- The synergistic effects of mechanical ventilation and intrauterine inflammation on cerebral inflammation in preterm fetal sheep.Frontiers in cellular neuroscience · 2024Article
- 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
- Mechanical ventilation induces brainstem inflammation in preterm fetal sheep.Frontiers in pediatrics · 2023Article
- Increased Prostaglandin E2 in Brainstem Respiratory Centers Is Associated With Inhibition of Breathing Movements in Fetal Sheep Exposed to Progressive Systemic Inflammation.Frontiers in physiology · 2022Article
- Investigating Pathways of Ventilation Induced Brain Injury on Cerebral White Matter Inflammation and Injury After 24 h in Preterm Lambs.Frontiers in physiology · 2022Article
- Circulating extracellular vesicles activate the pyroptosis pathway in the brain following ventilation-induced lung injury.Journal of neuroinflammation · 2021Article
- Is Chest Compression Superimposed with Sustained Inflation during Cardiopulmonary Resuscitation an Alternative to 3:1 Compression to Ventilation Ratio in Newborn Infants?Children (Basel, Switzerland) · 2021Review
- Perinatal care with a view to preventing cerebral palsy.Developmental medicine and child neurology · 2021Review
- The Role of Extracellular Vesicles in the Developing Brain: Current Perspective and Promising Source of Biomarkers and Therapy for Perinatal Brain Injury.Frontiers in neuroscience · 2021Review
1 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsPreterm infants can be inadvertently exposed to high tidal volumes (V(T)) in the delivery room, causing lung inflammation and injury, but little is known about their effects on the brain. The aim of this study was to compare an initial 15 min of high V(T) resuscitation strategy to a less injurious resuscitation strategy on cerebral haemodynamics, inflammation and injury.
methodsPreterm lambs at 126 d gestation were surgically instrumented prior to receiving resuscitation with either: 1) High V(T) targeting 10-12 mL/kg for the first 15 min (n = 6) or 2) a protective resuscitation strategy (Prot V(T)), consisting of prophylactic surfactant, a 20 s sustained inflation and a lower initial V(T) (7 mL/kg; n = 6). Both groups were subsequently ventilated with a V(T) 7 mL/kg. Blood gases, arterial pressures and carotid blood flows were recorded. Cerebral blood volume and oxygenation were assessed using near infrared spectroscopy. The brain was collected for biochemical and histologic assessment of inflammation, injury, vascular extravasation, hemorrhage and oxidative injury. Unventilated controls (UVC; n = 6) were used for comparison.
resultsHigh V(T) lambs had worse oxygenation and required greater ventilatory support than Prot V(T) lambs. High V(T) resulted in cerebral haemodynamic instability during the initial 15 min, adverse cerebral tissue oxygenation index and cerebral vasoparalysis. While both resuscitation strategies increased lung and brain inflammation and oxidative stress, High V(T) resuscitation significantly amplified the effect (p = 0.014 and p<0.001). Vascular extravasation was evident in the brains of 60% of High V(T) lambs, but not in UVC or Prot V(T) lambs.
conclusionHigh V(T) resulted in greater cerebral haemodynamic instability, increased brain inflammation, oxidative stress and vascular extravasation than a Prot V(T) strategy. The initiation of resuscitation targeting Prot V(T) may reduce the severity of brain injury in preterm neonates.
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