Protective Ventilation of Preterm Lambs Exposed to Acute Chorioamnionitis Does Not Reduce Ventilation-Induced Lung or Brain Injury

摘要: Background The onset of mechanical ventilation is a critical time for the initiation cerebral white matter (WM) injury in preterm neonates, particularly if they are inadvertently exposed to high tidal volumes (VT) delivery room. Protective strategies at birth reduce ventilation-induced lung and brain inflammation injury, however its efficacy compromised newborn not known. Chorioamnionitis common antecedent birth, increases risk severity WM injury. We investigated effects VT ventilation, after chorioamnionitis, on whether protective strategy could mitigate response. Methods Pregnant ewes (n = 18) received intra-amniotic lipopolysaccharide (LPS) 2 days before delivery, instrumentation 127±1 gestation. Lambs were either immediately euthanased used as unventilated controls (LPSUVC; n 6), or ventilated using an injurious (LPSINJ; 5) (LPSPROT; 7) total 90 min. Mean arterial pressure, heart rate haemodynamics oxygenation measured continuously. Lungs brains underwent molecular histological assessment injury. Results LPSINJ lambs had poorer than LPSPROT lambs. Ventilation requirements cardiopulmonary systemic different between strategies. Compared lambs, LPSINJ pro-inflammatory cytokine expression within lungs brain, increased astrogliosis (p<0.02) cell death (p<0.05) WM, which equivalent magnitude groups. Conclusions Ventilation acute irrespective used, haemodynamic instability Mechanical potential contributor infants chorioamnionitis.