Am J Perinatol 2019; 36(S 02): S110-S114
DOI: 10.1055/s-0039-1692133
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Sustained Inflation or Positive Pressure Ventilation on the Release of Adrenomedullin in Preterm Infants with Respiratory Failure at Birth

Azzurra La Verde
1   Neonatal Intensive Care Unit, V. Buzzi Children's Hospital, ASST-FBF-Sacco, Milan, Italy
,
Simone Franchini
2   Neonatal Intensive Care Unit, G. D'Annunzio University of Chieti, Chieti, Italy
,
Giuseppe Lapergola
2   Neonatal Intensive Care Unit, G. D'Annunzio University of Chieti, Chieti, Italy
,
Gianluca Lista
1   Neonatal Intensive Care Unit, V. Buzzi Children's Hospital, ASST-FBF-Sacco, Milan, Italy
,
Ignazio Barbagallo
3   Department of Biomedical and Biotechnological Sciences Section of Biochemistry, University of Catania, Catania, Italy
,
Giovanni Livolti
3   Department of Biomedical and Biotechnological Sciences Section of Biochemistry, University of Catania, Catania, Italy
,
Diego Gazzolo
2   Neonatal Intensive Care Unit, G. D'Annunzio University of Chieti, Chieti, Italy
4   Department of Maternal Fetal and Neonatal Medicine, C. Arrigo Children's Hospital Alessandria, Alessandria, Italy
› Author Affiliations
Funding This study is part of the I.O. PhD International Program, under the auspices of the Italian Society of Neonatology and of the Neonatal Clinical Biochemistry Research Group, and was partially supported by grants to Diego Gazzolo from “I Colori della Vita Foundation,” Italy.
Further Information

Publication History

Publication Date:
25 June 2019 (online)

Abstract

Objective Delivery room (DR) management may play an important role in the development and prevention of lung injury. Therefore, in a cohort of low birth weight infants (LBW), we investigated the effects of two different lung recruitment maneuvers, such as positive pressure ventilation (PPV) and sustained inflation (SI) on adrenomedullin (AM), a well-established lung-specific vasoactive agent.

Study Design This is a prospective case-control randomized study in 44 LBW infants spontaneously breathing with respiratory failure at birth requiring respiratory support. LBW were randomized to receive PPV (n = 22) or SI (n = 22) support. AM was measured from blood in samples collected at birth from arterial artery (BLT0) and at 1-hour (BLT1) and at 24-hour (BLT2) from peripheral venous site. AM assessment in urine samples was performed at 1-hour (URT1) and at 24-hour (URT2).

Results No significant differences in AM (p > 0.05) blood (T0–T2) and urine (T1, T2) levels were observed between groups.

Conclusion The present data, showing the absence of any differences in AM blood and urine levels, suggest that PPV and SI are both feasible and equally effective DR maneuvers. The findings open the way to further studies evaluating the effects of PPV and SI on short-/long-term respiratory outcome through biomarkers assessment.

 
  • References

  • 1 Chawla S, Foglia EE, Kapadia V, Wyckoff MH. Perinatal management: what has been learned through the network?. Semin Perinatol 2016; 40 (06) 391-397
  • 2 Lista G, Boni L, Scopesi F. , et al; SLI Trial Investigators. Sustained lung inflation at birth for preterm infants: a randomized clinical trial. Pediatrics 2015; 135 (02) e457-e464
  • 3 Gazzolo D, Abella R, Marinoni E. , et al. New markers of neonatal neurology. J Matern Fetal Neonatal Med 2009; 22 (Suppl. 03) 57-61
  • 4 Boldt T, Luukkainen P, Fyhrquist F, Pohjavuori M, Andersson S. Birth stress increases adrenomedullin in the newborn. Acta Paediatr 1998; 87 (01) 93-94
  • 5 Jobe AH, Bancalari EH. Controversies about the definition of bronchopulmonary dysplasia at 50 years. Acta Paediatr 2017; 106 (05) 692-693
  • 6 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92 (04) 529-534
  • 7 International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 2005; 123 (07) 991-999
  • 8 Bruschettini M, O'Donnell CP, Davis PG. , et al. Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes. Cochrane Database Syst Rev 2017; 7: CD004953
  • 9 Talero E, Di Paola R, Mazzon E, Esposito E, Motilva V, Cuzzocrea S. Anti-inflammatory effects of adrenomedullin on acute lung injury induced by Carrageenan in mice. Mediators Inflamm 2012; 2012: 717851
  • 10 Vadivel A, Abozaid S, van Haaften T. , et al. Adrenomedullin promotes lung angiogenesis, alveolar development, and repair. Am J Respir Cell Mol Biol 2010; 43 (02) 152-160
  • 11 Müller HC, Witzenrath M, Tschernig T. , et al. Adrenomedullin attenuates ventilator-induced lung injury in mice. Thorax 2010; 65 (12) 1077-1084
  • 12 de Vroomen M, Takahashi Y, Gournay V, Roman C, Rudolph AM, Heymann MA. Adrenomedullin increases pulmonary blood flow in fetal sheep. Pediatr Res 1997; 41 (4, Pt. 1): 493-497
  • 13 Rudolph AM. Adrenomedullin: its role in perinatal adaptation. Acta Paediatr 1998; 87 (03) 235-236
  • 14 Takahashi Y, de Vroomen M, Gournay V, Roman C, Rudolph AM, Heymann MA. Mechanisms of adrenomedullin-induced increase of pulmonary blood flow in fetal sheep. Pediatr Res 1999; 45 (02) 276-281
  • 15 Nossaman BD, Feng CJ, Kaye AD. , et al. Pulmonary vasodilator responses to adrenomedullin are reduced by NOS inhibitors in rats but not in cats. Am J Physiol 1996; 270 (5 Pt 1): L782-L789