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Mota-Rojas D, Braghieri A, Ghezzi M, Ceriani MC, Martínez-Burnes J, Lendez PA, Pereira AMF, Lezama-García K, Domínguez-Oliva A, Casas-Alvarado A, Sabia E, Pacelli C, Napolitano F. Strategies and Mechanisms of Thermal Compensation in Newborn Water Buffaloes. Animals (Basel) 2023; 13:2161. [PMID: 37443964 PMCID: PMC10340076 DOI: 10.3390/ani13132161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Hypothermia is one of the principal causes of perinatal mortality in water buffaloes and can range from 3% to 17.9%. In ruminants, factors affecting hypothermia in newborns may be of intrinsic (e.g., level of neurodevelopment, birth weight, vitality score, amount of brown fat, skin features) or extrinsic origin (e.g., maternal care, environmental conditions, colostrum consumption). When newborn buffaloes are exposed to cold stress, thermoregulatory mechanisms such as peripheral vasoconstriction and shivering and non-shivering thermogenesis are activated to prevent hypothermia. Due to the properties of infrared thermography (IRT), as a technique that detects vasomotor changes triggered by a reduction in body temperature, evaluating the central and peripheral regions in newborn buffaloes is possible. This review aims to analyze behavioral, physiological, and morphological strategies and colostrum consumption as thermal compensation mechanisms in newborn water buffalo to cope with environmental changes affecting thermoneutrality. In addition, the importance of monitoring by IRT to identify hypothermia states will be highlighted. Going deeper into these topics related to the water buffalo is essential because, in recent years, this species has become more popular and is being bred in more geographic areas.
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Affiliation(s)
- Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Ada Braghieri
- Scuola di Scienze Agrarie, Forestali, Alimentari ed Ambientali, Università degli Studi della Basilicata, 85100 Potenza, Italy
| | - Marcelo Ghezzi
- Animal Welfare Area, Faculty of Veterinary Sciences (FCV), Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), University Campus, Tandil 7000, Argentina
| | - María Carolina Ceriani
- Faculty of Veterinary Sciences, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Tandil, Veterinary Research Center (CIVETAN), CONICET-CICPBA, Arroyo Seco S/N, Campus Universitario, Tandil 7000, Argentina
| | - Julio Martínez-Burnes
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico
| | - Pamela Anahí Lendez
- Faculty of Veterinary Sciences, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Tandil, Veterinary Research Center (CIVETAN), CONICET-CICPBA, Arroyo Seco S/N, Campus Universitario, Tandil 7000, Argentina
| | - Alfredo M. F. Pereira
- Mediterranean Institute for Agriculture, Environment and Development (MED), Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Karina Lezama-García
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Alejandro Casas-Alvarado
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City 04960, Mexico
| | - Emilio Sabia
- School of Agricultural, Forest, Food, and Environmental Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Corrado Pacelli
- Scuola di Scienze Agrarie, Forestali, Alimentari ed Ambientali, Università degli Studi della Basilicata, 85100 Potenza, Italy
| | - Fabio Napolitano
- Scuola di Scienze Agrarie, Forestali, Alimentari ed Ambientali, Università degli Studi della Basilicata, 85100 Potenza, Italy
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钱 爱, 朱 雯, 杨 洋, 卢 刻, 王 加, 陈 许, 郭 楚, 陆 亚, 戎 惠, 程 锐. [Early risk factors for death in neonates with persistent pulmonary hypertension of the newborn treated with inhaled nitric oxide]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:507-513. [PMID: 35644190 PMCID: PMC9154377 DOI: 10.7499/j.issn.1008-8830.2111191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 04/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To evaluate the early risk factors for death in neonates with persistent pulmonary hypertension of the newborn (PPHN) treated with inhaled nitric oxide (iNO). METHODS A retrospective analysis was performed on 105 infants with PPHN (gestational age ≥34 weeks and age <7 days on admission) who received iNO treatment in the Department of Neonatology, Children's Hospital of Nanjing Medical University, from July 2017 to March 2021. Related general information and clinical data were collected. According to the clinical outcome at discharge, the infants were divided into a survival group with 79 infants and a death group with 26 infants. Univariate and multivariate Cox regression analyses were used to evaluate the risk factors for death in infants with PPHN treated with iNO. The receiver operating characteristic (ROC) curve was used to calculate the cut-off values of the factors in predicting the death risk. RESULTS A total of 105 infants with PPHN treated with iNO were included, among whom 26 died (26/105, 24.8%). The multivariate Cox regression analysis showed that no early response to iNO (HR=8.500, 95%CI: 3.024-23.887, P<0.001), 1-minute Apgar score ≤3 points (HR=10.094, 95%CI: 2.577-39.534, P=0.001), a low value of minimum PaO2/FiO2 within 12 hours after admission (HR=0.067, 95%CI: 0.009-0.481, P=0.007), and a low value of minimum pH within 12 hours after admission (HR=0.049, 95%CI: 0.004-0.545, P=0.014) were independent risk factors for death. The ROC curve analysis showed that the lowest PaO2/FiO2 value within 12 hours after admission had an area under the ROC curve of 0.783 in predicting death risk, with a sensitivity of 84.6% and a specificity of 73.4% at the cut-off value of 50, and the lowest pH value within 12 hours after admission had an area under the ROC curve of 0.746, with a sensitivity of 76.9% and a specificity of 65.8% at the cut-off value of 7.2. CONCLUSIONS Infants with PPHN requiring iNO treatment tend to have a high mortality rate. No early response to iNO, 1-minute Apgar score ≤3 points, the lowest PaO2/FiO2 value <50 within 12 hours after admission, and the lowest pH value <7.2 within 12 hours after admission are the early risk factors for death in such infants. Monitoring and evaluation of the above indicators will help to identify high-risk infants in the early stage.
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Kravtsov A, Kozin S, Basov A, Butina E, Baryshev M, Malyshko V, Moiseev A, Elkina A, Dzhimak S. Reduction of Deuterium Level Supports Resistance of Neurons to Glucose Deprivation and Hypoxia: Study in Cultures of Neurons and on Animals. Molecules 2021; 27:243. [PMID: 35011474 PMCID: PMC8746303 DOI: 10.3390/molecules27010243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022] Open
Abstract
The effect of a reduced deuterium (D) content in the incubation medium on the survival of cultured neurons in vitro and under glucose deprivation was studied. In addition, we studied the effect of a decrease in the deuterium content in the rat brain on oxidative processes in the nervous tissue, its antioxidant protection, and training of rats in the T-shaped maze test under hypoxic conditions. For experiments with cultures of neurons, 7-8-day cultures of cerebellar neurons were used. Determination of the rate of neuronal death in cultures was carried out using propidium iodide. Acute hypoxia with hypercapnia was simulated in rats by placing them in sealed vessels with a capacity of 1 L. The effect on oxidative processes in brain tissues was assessed by changes in the level of free radical oxidation and malondialdehyde. The effect on the antioxidant system of the brain was assessed by the activity of catalase. The study in the T-maze was carried out in accordance with the generally accepted methodology, the skill of alternating right-sided and left-sided loops on positive reinforcement was developed. This work has shown that a decrease in the deuterium content in the incubation medium to a level of -357‱ has a neuroprotective effect, increasing the survival rate of cultured neurons under glucose deprivation. When exposed to hypoxia, a preliminary decrease in the deuterium content in the rat brain to -261‱ prevents the development of oxidative stress in their nervous tissue and preserves the learning ability of animals in the T-shaped maze test at the level of the control group. A similar protective effect during the modification of the 2H/1H internal environment of the body by the consumption of DDW can potentially be used for the prevention of pathological conditions associated with the development of oxidative stress with damage to the central nervous system.
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Affiliation(s)
- Alexandr Kravtsov
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
| | - Stanislav Kozin
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
| | - Alexandr Basov
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- Department of Fundamental and Clinical Biochemistry, Kuban State Medical University, 350063 Krasnodar, Russia
| | - Elena Butina
- Department of Technology of Fats, Cosmetics, Commodity Science, Processes and Devices, Kuban State Technological University, 350072 Krasnodar, Russia;
| | - Mikhail Baryshev
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
- Department of Technology of Fats, Cosmetics, Commodity Science, Processes and Devices, Kuban State Technological University, 350072 Krasnodar, Russia;
| | - Vadim Malyshko
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
- Department of Fundamental and Clinical Biochemistry, Kuban State Medical University, 350063 Krasnodar, Russia
| | - Arkady Moiseev
- Department of Organization and Support of Scientific Activities, Kuban State Agrarian University, 350044 Krasnodar, Russia;
| | - Anna Elkina
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
- Department of Physics, K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), 109004 Moscow, Russia
| | - Stepan Dzhimak
- Department of Radiophysics and Nanothechnology, Physics Faculty, Kuban State University, 350040 Krasnodar, Russia; (A.K.); (S.K.); (A.B.); (M.B.); (A.E.)
- South Scientific Center of the Russian Academy of Sciences, Laboratory of Problems of Stable Isotope Spreading in Living Systems, 344006 Rostov-on-Don, Russia;
- The V.M. Gorbatov Federal Research Center for Food Systems of the Russian Academy of Sciences, Experimental Clinic—Laboratory of Biologically Active Substances of Animal Origin, 109316 Moscow, Russia
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Rossi L, Lumbreras AEV, Vagni S, Dell’Anno M, Bontempo V. Nutritional and Functional Properties of Colostrum in Puppies and Kittens. Animals (Basel) 2021; 11:ani11113260. [PMID: 34827992 PMCID: PMC8614261 DOI: 10.3390/ani11113260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The post-natal period is a crucial time for all animal species. During the course of their first two weeks of life, puppies and kittens face several risks to their health due to their scarce energy storage and weak immune system. Colostrum is the first production of the mammary glands that plays a pivotal role for puppies and kittens. Colostrum is an important source of immunoglobulins and key nutrients such as lipids and carbohydrates, which are fundamental for the health of newborns. Puppies and kittens must ingest a sufficient amount of colostrum within a few hours of birth to ensure their survival. On the other hand, there are some particular compounds that are not strictly essential, but their presence may play an important role in nutrition and health. As there are no recent studies on companion animals, we have reported published articles describing animal studies in different species to review the nutrition of newborn mammals, with particular emphasis on companion animals. Abstract The present review aims toward a better understanding of the nutrition of newborn puppies and kittens. The post-natal period is very sensitive in dogs and cats, as in other animal species. During the first two weeks of life, puppies and kittens are at high risk of dehydration, hypothermia, and hypoglycemia, as well as infectious diseases as they start to acquire the physiological functions of the adult. Neonatal hepatic glycogen storage is low, and newborns depend on colostrum intake to survive. Colostrum provides immunoglobulins and other important substances such as lipids and carbohydrates. Immunoglobulins are central to the immunological link that occurs when the mother transfers passive immunity. The mechanism of transfer varies among mammalian species, but in this review, we focused our attention on dogs and cats. Furthermore, there are components of colostrum which, although their presence is not absolutely necessary, play an important role in nutrition. These components have received considerable interest because of their presumed safety and potential nutritional and therapeutic effects both in humans and animals; however, unfortunately, there are few recent studies in companion animals. Here, we have gathered the published articles that describe studies involving different species of animals, emphasizing companion animals. In particular, the purpose of this narrative of the nutritional and functional proprieties of queens’ and bitches’ colostrum.
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Reyes-Sotelo B, Mota-Rojas D, Mora-Medina P, Ogi A, Mariti C, Olmos-Hernández A, Martínez-Burnes J, Hernández-Ávalos I, Sánchez-Millán J, Gazzano A. Blood Biomarker Profile Alterations in Newborn Canines: Effect of the Mother's Weight. Animals (Basel) 2021; 11:2307. [PMID: 34438764 PMCID: PMC8388527 DOI: 10.3390/ani11082307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022] Open
Abstract
This study aims to determine the effect of the weight of bitches on liveborn and stillbirth puppies from eutocic births, and physiological blood alterations during the first minute postpartum. A total of 52 female dogs were evaluated and distributed in four categories: C1 (4.0-8.0 kg, n = 19), C2 (8.1-16.0 kg, n = 16), C3 (16.1-32.0 kg, n = 11), and C4 (32.1-35.8 kg, n = 6). The dams produced 225 liveborn puppies and 47 were classified as stillbirth type II. Blood samples were taken from the umbilical vein to evaluate the concentration of gases, glucose, lactate, calcium, hematocrit levels, and blood pH. The liveborn puppies in C2, C3, and C4 had more evident physiological alterations (hypercapnia, acidosis) than those in C1 (p < 0.05). These signs indicate a process of transitory asphyxiation. The stillborn pups in all four categories had higher weights than their liveborn littermates. C3 and C4 had the highest mean weights (419.86 and 433.79 g, respectively) and mortality rates (C3 = 20.58%, C4 = 24.58%). Results suggest that if the weight of the bitch is >16.1 kg in eutocic births, there is a higher risk of intrapartum physiological alterations and death. The results of this study allowed us to identify that the weight of dams before birth determines the weight of the puppies at birth.
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Affiliation(s)
- Brenda Reyes-Sotelo
- Science Program “Maestria en Ciencias Agropecuarias”, Xochimilco Campus, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico;
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assesment, DPAA, Xochimilco Campus, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
| | - Patricia Mora-Medina
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de Mexico (UNAM), Cuautitlán Izcalli 54714, Mexico; (P.M.-M.); (I.H.-Á.); (J.S.-M.)
| | - Asahi Ogi
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (A.O.); (C.M.); (A.G.)
| | - Chiara Mariti
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (A.O.); (C.M.); (A.G.)
| | - Adriana Olmos-Hernández
- Division of Biotechnology-Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City 14389, Mexico;
| | - Julio Martínez-Burnes
- Animal Health Group, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Mexico;
| | - Ismael Hernández-Ávalos
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de Mexico (UNAM), Cuautitlán Izcalli 54714, Mexico; (P.M.-M.); (I.H.-Á.); (J.S.-M.)
| | - Jose Sánchez-Millán
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de Mexico (UNAM), Cuautitlán Izcalli 54714, Mexico; (P.M.-M.); (I.H.-Á.); (J.S.-M.)
| | - Angelo Gazzano
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (A.O.); (C.M.); (A.G.)
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Giannakis S, Ruhfus M, Markus M, Stein A, Hoehn T, Felderhoff-Mueser U, Sabir H. Mechanical Ventilation, Partial Pressure of Carbon Dioxide, Increased Fraction of Inspired Oxygen and the Increased Risk for Adverse Short-Term Outcomes in Cooled Asphyxiated Newborns. CHILDREN-BASEL 2021; 8:children8060430. [PMID: 34063852 PMCID: PMC8224013 DOI: 10.3390/children8060430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/04/2021] [Accepted: 05/18/2021] [Indexed: 11/26/2022]
Abstract
Neonates treated with therapeutic hypothermia (TH) following perinatal asphyxia (PA) suffer a considerable rate of disability and mortality. Several risk factors associated with adverse outcomes have been identified. Mechanical ventilation might increase the risk for hyperoxia and hypocapnia in cooled newborns. We carried out a retrospective study in 71 asphyxiated cooled newborns. We analyzed the association of ventilation status and adverse short-term outcomes and investigated the effect of the former on pCO2 and oxygen delivery before, during and after TH. Death, abnormal findings on magnetic resonance imaging, and pathological amplitude-integrated electroencephalography traces were used to define short-term outcomes. The need for mechanical ventilation was significantly higher in the newborns with adverse outcomes (38% vs. 5.6%, p = 0.001). Compared to spontaneously breathing neonates, intubated newborns suffered from significantly more severe asphyxia, had significantly lower levels of mean minimum pCO2 over the first 6 and 72 h of life (HOL) (p = 0.03 and p = 0.01, respectively) and increased supply of inspired oxygen, which was, in turn, significantly higher in the newborns with adverse outcomes (p < 0.01). Intubated newborns with adverse short-term outcomes had lower levels of pCO2 over the first 36 HOL. In conclusion, need for mechanical ventilation was significantly higher in newborns with more severe asphyxia. In ventilated newborns, level of encephalopathy, lower pCO2 levels, and increased oxygen supplementation were significantly higher in the adverse short-term outcomes group. Ventilatory parameters need to be carefully monitored in cooled asphyxiated newborns.
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Affiliation(s)
- Stamatios Giannakis
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Faculty of Medicine, University Children’s Hospital, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany; (S.G.); (M.M.); (T.H.)
| | - Maria Ruhfus
- Department of Pediatrics I/Neonatology, University Hospital Essen, University Duisburg Essen, 45147 Essen, Germany; (M.R.); (A.S.); (U.F.-M.)
| | - Mona Markus
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Faculty of Medicine, University Children’s Hospital, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany; (S.G.); (M.M.); (T.H.)
| | - Anja Stein
- Department of Pediatrics I/Neonatology, University Hospital Essen, University Duisburg Essen, 45147 Essen, Germany; (M.R.); (A.S.); (U.F.-M.)
| | - Thomas Hoehn
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Faculty of Medicine, University Children’s Hospital, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany; (S.G.); (M.M.); (T.H.)
| | - Ursula Felderhoff-Mueser
- Department of Pediatrics I/Neonatology, University Hospital Essen, University Duisburg Essen, 45147 Essen, Germany; (M.R.); (A.S.); (U.F.-M.)
| | - Hemmen Sabir
- Department of Pediatrics I/Neonatology, University Hospital Essen, University Duisburg Essen, 45147 Essen, Germany; (M.R.); (A.S.); (U.F.-M.)
- Department of Neonatology and Pediatric Intensive Care, Children’s Hospital University of Bonn, 53127 Bonn, Germany
- German Centre for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Correspondence:
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Zhao Y, Liang L, Liu G, Zheng H, Dai L, Wang Y, Wang L, Sheng W. Asphyxia and Neonatal Respiratory Distress Syndrome Are Independent Predictors of the Non-response to Inhaled Nitric Oxide in the Newborns With PPHN. Front Pediatr 2021; 9:665830. [PMID: 34095030 PMCID: PMC8172584 DOI: 10.3389/fped.2021.665830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN). Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 < 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed. Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104-15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036-0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups. Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.
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Affiliation(s)
- Yuwei Zhao
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Lei Liang
- Pulmonary Department, Anhui Provincial Children Hospital, Hefei, China
| | - Guanghui Liu
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Hong Zheng
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Liying Dai
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Yan Wang
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Lei Wang
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
| | - Weiting Sheng
- Neonatology Department, Anhui Provincial Children Hospital, Hefei, China
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Wedgwood S, Steinhorn RH, Lakshminrusimha S. Optimal oxygenation and role of free radicals in PPHN. Free Radic Biol Med 2019; 142:97-106. [PMID: 30995536 PMCID: PMC6761018 DOI: 10.1016/j.freeradbiomed.2019.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/01/2019] [Indexed: 02/07/2023]
Abstract
Effective ventilation of the lungs is essential in mediating pulmonary vasodilation at birth to allow effective gas exchange and an increase in systemic oxygenation. Unsuccessful transition prevents the increase in pulmonary blood flow after birth resulting in hypoxemia and persistent pulmonary hypertension of the newborn (PPHN). Management of neonates with PPHN includes ventilation of the lungs with supplemental oxygen to correct hypoxemia. Optimal oxygenation should meet oxygen demand to the tissues and avoid hypoxic pulmonary vasoconstriction (HPV) while preventing oxidative stress. The optimal target for oxygenation in PPHN is not known. Animal models have demonstrated that PaO2<45 mmHg exacerbates HPV. However, there are no practical methods of assessing oxygen levels associated with oxidant stress. Oxidant stress can be due to free radical generation from underlying lung disease or from free radicals generated by supplemental oxygen. Free radicals act on the nitric oxide pathway reducing cGMP and promoting pulmonary vasoconstriction. Antioxidant therapy improves systemic oxygenation in an animal model of PPHN but there are no clinical trials to support such therapy. Targeting preductal SpO2 between 90 and 97% and PaO2 at 50-80 mmHg appears prudent in PPHN but clinical trials to support this practice are lacking. Preterm infants with PPHN present unique challenges due to lack of antioxidant defenses and functional and structural immaturity of the lungs. This review highlights the need for additional studies to mitigate the impact of oxidative stress in the lung and pulmonary vasculature in PPHN.
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Affiliation(s)
- Stephen Wedgwood
- Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA, USA
| | - Robin H Steinhorn
- Department of Hospitalist Medicine, Children's National Health System, Washington DC, USA
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Li WX, Qu Y, Mu DZ, Tang J. [A review on the relationship between mitochondrial dysfunction and white matter injury in preterm infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:864-869. [PMID: 30369366 PMCID: PMC7389051 DOI: 10.7499/j.issn.1008-8830.2018.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
White matter injury in preterm infants has a complex etiology and can lead to long-term neurocognitive and behavioral deficits, but there are still no specific treatment methods for this disease at present. More and more studies have shown that mitochondrial dysfunction plays an important role in the pathogenesis of white matter injury in preterm infants and might be a common subcellular mechanism of white matter developmental disorder, which involves oxidative stress, reduced ATP synthesis, and disequilibrium of calcium homeostasis. This article reviews the role of mitochondria in brain development and the mechanism of mitochondrial dysfunction, with a hope to perform early intervention of white matter injury in preterm infants by protecting mitochondrial function, so as to provide a reference for improving the neurodevelopmental outcome of preterm infants who survive.
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Affiliation(s)
- Wen-Xing Li
- Department of Pediatrics, West China Second Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.
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