Hemodynamic effects of epinephrine, bicarbonate and calcium in the early postnatal period in a lamb model of single-ventricle physiology created in utero

Journal of the American College of Cardiology
V M ReddyF L Hanley

Abstract

A reproducible fetal animal model of single-ventricle physiology was created to examine the effects of pharmacologic agents commonly used in the perinatal and perioperative intensive care management of patients with a single ventricle. Single-ventricle physiology is characterized by parallel pulmonary and systemic circulations, with effective blood flow to each determined by the relative resistances in the pulmonary and systemic vascular beds. Perinatal and perioperative management of these patients is largely based on empiric observations and differs considerably between institutions and is further complicated by the transitional physiology of the newborn. The lack of animal models of single-ventricle physiology has hindered the understanding of this problem. A 10-mm, Damus-Kaye-Stansel-type aortopulmonary anastomosis was created in 10 fetal sheep at 140 +/- 1.2 days of gestation. The main pulmonary artery was ligated distally, and pulmonary blood flow (Qp) was provided through a 5-mm aortopulmonary shunt. Eight lambs were delivered at term and placed on cardiopulmonary bypass (30 min) 48 to 72 h after birth. Pharmacologic interventions (0.1 microgram/kg body weight per min of epinephrine, 2 mEq/kg of sodium bicarbonate and 10...Continue Reading

References

Jul 11, 1992·The Annals of Thoracic Surgery·D R JobesW I Norwood
Nov 1, 1994·Journal of the American College of Cardiology·O BarneaW P Santamore
Jun 28, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Christian Pizarro, William I Norwood

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Citations

Oct 4, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·David M AxelrodUNKNOWN Board Members of the Pediatric Cardiac Intensive Care Society
May 4, 2013·Pediatric Clinics of North America·Ronald A Bronicki, Paul A Checchia
Oct 11, 2005·The Journal of Thoracic and Cardiovascular Surgery·Marco RicciEliot Rosenkranz
Dec 12, 2013·World Journal for Pediatric & Congenital Heart Surgery·William M DeCampliHamish M Munro
Mar 17, 2010·Circulation·Doff B McElhinneyJames E Lock
Jul 20, 2011·Critical Care Medicine·Ronald A Bronicki, Anthony C Chang
Aug 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Ronald A BronickiHarris Baden

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