Activation of the inflammatory reaction within minutes after birth in ventilated preterm lambs with neonatal respiratory distress syndrome

• Published in: Biology of the neonate Vol. 86; no. 1; pp. 1 - 5
• Main Authors: JAARSMA, Anneke S, BRAAKSMA, Margriethe A, GEVEN, Wil B, VAN OEVEREN, Wim, OETOMO, Sidarto Bambang
• Format: Journal Article
• Language: English
• Published: Basel Karger 01.01.2004; S. Karger AG
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Animals, Newborn; Biological and medical sciences; Complement System Proteins; Delivery. Postpartum. Lactation; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Fetal Blood - chemistry; Fetal Blood - cytology; Gestational Age; Glucuronidase - blood; Gynecology. Andrology. Obstetrics; Inflammation - blood; Inflammation - complications; Intensive care medicine; Leukocyte Count; Lung Diseases - blood; Lung Diseases - complications; Medical sciences; Neutrophils; Oxygen - blood; Pneumology; Respiration, Artificial; Respiratory system : syndromes and miscellaneous diseases; Sheep; Time Factors; Premature; Polymorphonuclear leukocytes; Pregnancy disorders; Respiratory disease; Premature delivery; Neonatology; Neonatal distress; Activation; Inflammation; Lamb; Vertebrata; Mammalia; Prematurity; Respiratory distress syndrome; Newborn animal; Respiratory distress; Sheep; Ventilation; Artiodactyla; Ungulata
• ISSN: 0006-3126; 1661-7800; 1421-9727; 1661-7819
• DOI: 10.1159/000076366

To study the activation of the inflammatory reaction within minutes after birth, we measured parameters of inflammation before and immediately after birth. To assess whether respiratory distress syndrome (RDS) or birth itself initiates activation, we compared preterm ventilated lambs with term nonventilated lambs. Preterm lambs were delivered by cesarean section at 132 days gestational age (term 145 days) and were ventilated by conventional ventilation (n = 9). Before clamping the cord, 5, 10 and 15 min after birth, blood was sampled from umbilical catheters. Term lambs (n = 9) were born spontaneously after 140-145 days gestational age. Immediately after birth, a venous umbilical catheter was inserted. Blood was sampled before the first breath and 5, 10, 15 and 20 min after birth while the lamb was breathing spontaneously. Blood was analyzed for AP50 (complement activation), number of polymorphonuclear leukocytes (PMNs) and beta-glucuronidase (released from activated PMNs). In preterm lambs, we found a decreased number of PMNs and increased levels of beta-glucuronidase already at 5 min after birth. In the term lambs, we found only a short-term mild decrease in PMNs and short-term increase in beta-glucuronidase. We conclude that systemic activation of the inflammatory reaction can be found in ventilated preterm lambs with RDS within 5 min after birth. This very early activation is mild, transient and less pronounced in term-born spontaneously breathing lambs compared with preterm, ventilated lambs with RDS.