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Divisions of 1 Neonatology and 2 Pulmonary Disease and 3 Department of Research, Mount Sinai Medical Center, Miami Beach, Florida 33140
The hemodynamic effects of periodic acceleration (pGz), induced in the spinal axis with noninvasive motion ventilation (NIMV), were studied in a piglet model of pulmonary hypertension associated with meconium aspiration. Animals (n = 12) were anesthetized, paralyzed, intubated, and supported by conventional mechanical ventilation (CMV). Thirty minutes after tracheal instillation of meconium solution (6 ml/kg), either CMV (n = 6) was continued or NIMV (n = 6) was initiated. Changes in systemic and pulmonary hemodynamics and arterial blood gases were tracked for 2 h after aspiration. Thermodilution, cardiac output, and heart rate were not significantly different after meconium aspiration in the pGz group relative to the CMV controls. Aortic pressure and systemic vascular resistance were significantly lower (~30%) after meconium aspiration in NIMV animals relative to CMV animals. Pulmonary arterial pressure and pulmonary vascular resistance were also significantly lower, by 100%, after aspiration of meconium in the NIMV animals compared with the CMV controls. Meconium aspiration significantly decreased total respiratory compliance by ~50% and increased total respiratory resistance by ~100% in both CMV and NIMV animals, but such alterations did not differ between the two groups. Both CMV and NIMV satisfactorily supported ventilation in these paralyzed animals. In conclusion, NIMV through pGz in the spinal axis decreased systemic and pulmonary vascular resistance in piglets after meconium aspiration.
inertial forces; pulmonary hypertension; vasodilatation; arterial pulsation; cardiac output
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