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1 Brown University School of Medicine, Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Providence, Rhode Island 02905; and 2 Department of Surgery, SUNY at Stony Brook, Stony Brook, New York 11794-8191
We have been studying the ontogeny of the
blood-brain barrier function in ovine fetuses and lambs. During these
studies, we have found that the duration of ventilation also influences
blood-brain barrier permeability in premature lambs. Chronically
instrumented hysterotomy-delivered surfactant-treated premature lambs
were studied at 90% or 137 days of gestation (n = 9).
Blood-brain barrier function was quantified with the blood-to-brain
transfer constant Ki to 
-aminoisobutyric acid.
Linear regression analysis was used to compare the
Ki values in the brain regions, as the dependent variable, to the duration of ventilation, as the independent variable. There were direct correlations (P < 0.05) between the
Ki values and the duration of ventilation
[306 min (mean), 162-474 min (range)] in the cerebral
cortex, cerebellum, medulla, caudate nucleus, hippocampus, superior
colliculus, inferior colliculus, thalamus, pons, cervical spinal cord,
and choroid plexus, but not in the pituitary gland. Ventilatory
pressures and rates were established before the onset of the
permeability studies. Calculated mean airway pressures [14
cmH2O (mean), 7-20 cmH2O (range)]
from similarly studied premature lambs did not correlate with the
duration of positive-pressure ventilation. We conclude that increases
in the duration of positive-pressure ventilation predispose premature lambs to increases in regional blood-brain barrier permeability. These
alterations in barrier function occur over relatively short time
intervals (minutes to hours). In our study, these changes in
permeability are most likely not attributable to changes in mean airway pressure.
regional blood-brain barrier permeability
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