title: Intrauterine inflammation alters cardiopulmonary but not cerebral hemodynamics during open endotracheal tube suction in preterm lambs.
abstract: BACKGROUND
  Intrauterine inflammation adversely affects cardiopulmonary, systemic, and cerebral hemodynamics in preterm neonates, but its impact on responses to endotracheal tube (ETT) suction, known to affect hemodynamics, is unknown. We hypothesized that intrauterine inflammation would alter the cardiopulmonary and cerebral hemodynamic response to open ETT suction in preterm lambs.
  
  
  METHODS
  Chronically instrumented fetuses received intra-amniotic lipopolysaccharide (LPS; to induce intrauterine inflammation) or saline at 118 d of gestation (term ~147 d). At 125 d of gestation, lambs were delivered and mechanically ventilated. Open ETT suction was performed 30 min after delivery. Pulmonary and cerebral arterial pressures and flows were recorded continuously.
  
  
  RESULTS
  Intrauterine inflammation reduced pulmonary blood flow (PBF) and increased pulmonary vascular resistance (PVR) after preterm birth. PBF and left-ventricular output (LVO) increased during and immediately after ETT suction in both groups, but the values were higher in LPS-exposed lambs. Preductal oxygenation significantly decreased during ETT suction but to a greater extent in LPS-exposed lambs. Cerebral blood flow and systemic arterial pressure were increased by open ETT suction similarly in the two groups.
  
  
  CONCLUSIONS
  Intrauterine inflammation exacerbates the neonatal hemodynamic response to open ETT suction.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia. r.galinsky@auckland.ac.nz
authors.forename: Robert
authors.initials: R
authors.lastname: Galinsky
authors.forename: Timothy J M
authors.initials: TJ
authors.lastname: Moss
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Polglase
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Hooper
mesh_terms: D000818:Animals; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004716:Endometritis / Q000503:physiopathology*; D005260:Female; D007442:Intubation, Intratracheal; D008168:Lung / Q000098:blood supply*; D008297:Male; D012756:Sheep; D013396:Suction