Le Duc Kévin, Aubry Estelle, Mur Sébastien, Besengez Capucine, Garabedian Charles, De Jonckheere Julien, Storme Laurent, Sharma Dyuti
Univ. Lille, ULR2694 Metrics-Perinatal Environment and Health, F-59000 Lille, France.
CHU Lille, Department of Neonatology, Jeanne de Flandre Hospital, F-59000 Lille, France.
Children (Basel). 2021 Apr 26;8(5):337. doi: 10.3390/children8050337.
Some previous studies reported a benefit to cardiopulmonary transition at birth when starting resuscitation maneuvers while the cord was still intact for a short period of time. However, the best timing for umbilical cord clamping in this condition is unknown. The aim of this study was to explore the duration of effective umbilico-placental circulation able to promote cardiorespiratory adaptation at birth during intact cord resuscitation. Umbilico-placental blood flow and vascular resistances were measured in an experimental neonatal lamb model. After a C-section delivery, the lambs were resuscitated ventilated for 1 h while the cord was intact. The maximum and mean umbilico-placental blood flow were respectively 230 ± 75 and 160 ± 12 mL·min during the 1 h course of the experiment. However, umbilico-placental blood flow decreased and vascular resistance increased significantly 40 min after birth ( < 0.05). These results suggest that significant cardiorespiratory support can be provided by sustained placental circulation for at least 1 h during intact cord resuscitation.
一些先前的研究报告称，在出生时进行心肺过渡时，如果在脐带仍完好的短时间内开始复苏操作会有好处。然而，在这种情况下脐带 clamping 的最佳时机尚不清楚。本研究的目的是探讨在完整脐带复苏过程中，能够促进出生时心肺适应的有效脐 - 胎盘循环持续时间。在实验性新生羔羊模型中测量了脐 - 胎盘血流量和血管阻力。剖宫产分娩后，羔羊在脐带完整的情况下进行复苏通气 1 小时。在实验的 1 小时过程中，最大和平均脐 - 胎盘血流量分别为 230±75 和 160±12 mL·min。然而，出生后 40 分钟时，脐 - 胎盘血流量显著下降，血管阻力显著增加（<0.05）。这些结果表明，在完整脐带复苏过程中，持续的胎盘循环至少可持续 1 小时，从而提供显著的心肺支持。
