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. 1999 Jan;80(1):F30–F33. doi: 10.1136/fn.80.1.f30

Cerebral blood flow during treatment for pulmonary hypertension

S Kusuda, N Shishida, N Miyagi, M Hirabayashi, T Kim
PMCID: PMC1720885  PMID: 10325808

Abstract

AIM—To determine if the haemodynamics of systemic and cerebral circulation are changed during treatment for persistent pulmonary hypertension of the newborn (PPHN).
METHODS—Fifteen term newborn piglets with hypoxia induced pulmonary hypertension were randomly assigned either tolazoline infusion (Tz), hyperventilation alkalosis (HAT), and inhaled nitric oxide (iNO). Mean pulmonary arterial pressure (PAP), mean systemic arterial pressure (SAP), and cerebral blood flow volume (CBF) were measured.
 RESULTS—During hypoxic breathing, PAP increased significantly in all groups. After treatment PAP decreased significantly in all groups, but no significant difference was observed between groups. SAP decreased significantly only in the Tz group, and CBF reduced significantly only in the HAT group. On the other hand, iNO did not change SAP or CBF.
CONCLUSION—Inhaled NO might be ideal for the resolution of pulmonary hypertension.



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Selected References

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  1. Bifano E. M., Pfannenstiel A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics. 1988 May;81(5):657–661. [PubMed] [Google Scholar]
  2. Clark R. H. High-frequency ventilation. J Pediatr. 1994 May;124(5 Pt 1):661–670. doi: 10.1016/s0022-3476(05)81352-6. [DOI] [PubMed] [Google Scholar]
  3. Fratacci M. D., Frostell C. G., Chen T. Y., Wain J. C., Jr, Robinson D. R., Zapol W. M. Inhaled nitric oxide. A selective pulmonary vasodilator of heparin-protamine vasoconstriction in sheep. Anesthesiology. 1991 Dec;75(6):990–999. doi: 10.1097/00000542-199112000-00011. [DOI] [PubMed] [Google Scholar]
  4. Frostell C., Fratacci M. D., Wain J. C., Jones R., Zapol W. M. Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation. 1991 Jun;83(6):2038–2047. doi: 10.1161/01.cir.83.6.2038. [DOI] [PubMed] [Google Scholar]
  5. Gleason C. A., Short B. L., Jones M. D., Jr Cerebral blood flow and metabolism during and after prolonged hypocapnia in newborn lambs. J Pediatr. 1989 Aug;115(2):309–314. doi: 10.1016/s0022-3476(89)80091-5. [DOI] [PubMed] [Google Scholar]
  6. Greisen G. Cerebral blood flow and energy metabolism in the newborn. Clin Perinatol. 1997 Sep;24(3):531–546. [PubMed] [Google Scholar]
  7. Haaland K., Karlsson B., Skovlund E., Lagercrantz H., Thoresen M. Postnatal development of the cerebral blood flow velocity response to changes in CO2 and mean arterial blood pressure in the piglet. Acta Paediatr. 1995 Dec;84(12):1414–1420. doi: 10.1111/j.1651-2227.1995.tb13579.x. [DOI] [PubMed] [Google Scholar]
  8. Kinsella J. P., Abman S. H. Recent developments in the pathophysiology and treatment of persistent pulmonary hypertension of the newborn. J Pediatr. 1995 Jun;126(6):853–864. doi: 10.1016/s0022-3476(95)70197-4. [DOI] [PubMed] [Google Scholar]
  9. Kinsella J. P., Neish S. R., Shaffer E., Abman S. H. Low-dose inhalation nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992 Oct 3;340(8823):819–820. doi: 10.1016/0140-6736(92)92687-b. [DOI] [PubMed] [Google Scholar]
  10. Kinsella J. P., Truog W. E., Walsh W. F., Goldberg R. N., Bancalari E., Mayock D. E., Redding G. J., deLemos R. A., Sardesai S., McCurnin D. C. Randomized, multicenter trial of inhaled nitric oxide and high-frequency oscillatory ventilation in severe, persistent pulmonary hypertension of the newborn. J Pediatr. 1997 Jul;131(1 Pt 1):55–62. doi: 10.1016/s0022-3476(97)70124-0. [DOI] [PubMed] [Google Scholar]
  11. Lopes Cardozo R. H., de Beaufort A. J., Gesink B. J., Moison R. M., van de Bor M., Berger H. M., van Bel F. Inhalation of nitric oxide: effect on cerebral hemodynamics and activity, and antioxidant status in the newborn lamb. Biol Neonate. 1996;69(4):284–292. doi: 10.1159/000244322. [DOI] [PubMed] [Google Scholar]
  12. Roberts J. D., Jr, Fineman J. R., Morin F. C., 3rd, Shaul P. W., Rimar S., Schreiber M. D., Polin R. A., Zwass M. S., Zayek M. M., Gross I. Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. The Inhaled Nitric Oxide Study Group. N Engl J Med. 1997 Feb 27;336(9):605–610. doi: 10.1056/NEJM199702273360902. [DOI] [PubMed] [Google Scholar]
  13. Roberts J. D., Jr, Shaul P. W. Advances in the treatment of persistent pulmonary hypertension of the newborn. Pediatr Clin North Am. 1993 Oct;40(5):983–1004. doi: 10.1016/s0031-3955(16)38619-9. [DOI] [PubMed] [Google Scholar]
  14. Roberts J. D., Polaner D. M., Lang P., Zapol W. M. Inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992 Oct 3;340(8823):818–819. doi: 10.1016/0140-6736(92)92686-a. [DOI] [PubMed] [Google Scholar]
  15. Rosenberg A. A., Kinsella J. P., Abman S. H. Cerebral hemodynamics and distribution of left ventricular output during inhalation of nitric oxide. Crit Care Med. 1995 Aug;23(8):1391–1397. doi: 10.1097/00003246-199508000-00013. [DOI] [PubMed] [Google Scholar]
  16. Short B. L., Miller M. K., Anderson K. D. Extracorporeal membrane oxygenation in the management of respiratory failure in the newborn. Clin Perinatol. 1987 Sep;14(3):737–748. [PubMed] [Google Scholar]
  17. Stevenson D. K., Kasting D. S., Darnall R. A., Jr, Ariagno R. L., Johnson J. D., Malachowski N., Beets C. L., Sunshine P. Refractory hypoxemia associated with neonatal pulmonary disease: the use and limitations of tolazoline. J Pediatr. 1979 Oct;95(4):595–599. doi: 10.1016/s0022-3476(79)80777-5. [DOI] [PubMed] [Google Scholar]
  18. Ward R. M. Pharmacology of tolazoline. Clin Perinatol. 1984 Oct;11(3):703–713. [PubMed] [Google Scholar]
  19. Younkin D. P., Reivich M., Jaggi J. L., Obrist W. D., Delivoria-Papadopoulos M. The effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants. J Cereb Blood Flow Metab. 1987 Jun;7(3):295–299. doi: 10.1038/jcbfm.1987.66. [DOI] [PubMed] [Google Scholar]
  20. van Bel F., Sola A., Roman C., Rudolph A. M. Perinatal regulation of the cerebral circulation: role of nitric oxide and prostaglandins. Pediatr Res. 1997 Sep;42(3):299–304. doi: 10.1203/00006450-199709000-00009. [DOI] [PubMed] [Google Scholar]

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