Abstract:
:In its normal circulatory environment, the fetal left ventricle can maximally increase output less than 2-fold, in contrast to the nearly 3-fold increase that occurs at birth. Several studies have attributed this finding to fetal myocardial "immaturity," and speculated that there is a rapid maturation of the myocardium in the perinatal period. We investigated the importance of the circulatory environment itself, rather than myocardial immaturity, by measuring left ventricular output (LVO) during in utero oxygen ventilation and isoproterenol infusion. We studied seven near-term fetal sheep greater than or equal to 2 d after placement of intravascular catheters, an endotracheal tube, and an electromagnetic flow transducer around the ascending aorta. We measured hemodynamic variables in the presence and absence of all combinations of oxygen ventilation, isoproterenol infusion, and volume infusion. Baseline LVO was normal (133 +/- 27 mL.kg-1.min-1). Individually, oxygen ventilation (136 +/- 11 mL.kg-1.min-1, p less than 0.001) and isoproterenol (48 +/- 11 mL.kg-1.min-1, p less than 0.05) increased LVO significantly; volume infusion did not. Their cumulative effect increased LVO nearly 3-fold (to 387 +/- 98 mL.kg-1.min-1), similar to levels seen in the newborn lamb. Mean left atrial pressure increased above right during oxygen ventilation (from 0.05 +/- 0.54 kPa to 0.82 +/- 0.39 kPa, p less than or equal to 0.0001). We conclude that the previously observed limitation in maximal LVO in the near-term fetus is primarily caused by its circulatory environment rather than relative myocardial immaturity, and speculate that a prominent Starling response is uncovered by decreases in left ventricular afterload and right ventricular constraint.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Teitel DF,Dalinghaus M,Cassidy SC,Payne BD,Rudolph AMdoi
10.1203/00006450-199105010-00011subject
Has Abstractpub_date
1991-05-01 00:00:00pages
466-72issue
5eissn
0031-3998issn
1530-0447journal_volume
29pub_type
杂志文章abstract::Two infants with disorders of propionate metabolism were studied at 7 months of age to determine optimum levels of intake of protein and calories to meet the requirements for essential amino acid for growth in infancy, and at the same time minimize the accumulation of toxic intermediates. An effect of alanine was foun...
journal_title:Pediatric research
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doi:10.1203/00006450-198501000-00023
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abstract::In Chinese children with steroid-resistant nephrotic syndrome (SRNS), it was reported that NPHS2 mutation was detected in 4.3%, which was lower than that in Caucasians (10-30%). However, there were no data on WT1 mutation in nephrotic syndrome (NS), especially in early-onset NS of Chinese children. Thus, a study, whic...
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abstract::Neutrophils contribute to ischemic brain injury in adult animals. The role of neutrophils in perinatal hypoxic-ischemic (HI) brain injury is unknown. Allopurinol reduces neutrophil accumulation after tissue ischemia and is protective against HI brain injury. This study was designed to investigate how neutrophils contr...
journal_title:Pediatric research
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journal_title:Pediatric research
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journal_title:Pediatric research
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doi:10.1203/00006450-199110000-00014
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journal_title:Pediatric research
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更新日期:2013-04-01 00:00:00
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journal_title:Pediatric research
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doi:10.1203/00006450-199107000-00016
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journal_title:Pediatric research
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更新日期:2003-11-01 00:00:00
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更新日期:2014-10-01 00:00:00
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journal_title:Pediatric research
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更新日期:2008-01-01 00:00:00
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journal_title:Pediatric research
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