Comparison of intraosseous and intravenous epinephrine administration during resuscitation of asphyxiated newborn lambs.

Objective: Intraosseous access is recommended as a reasonable alternative for vascular access during newborn resuscitation if umbilical access is unavailable, but there are minimal reported data in newborns. We compared intraosseous with intravenous epinephrine administration during resuscitation of severely asphyxiated lambs at birth.

Methods: Near-term lambs (139 days' gestation) were instrumented antenatally for measurement of carotid and pulmonary blood flow and systemic blood pressure.

Early lung ultrasound affords little to the prediction of bronchopulmonary dysplasia.

Objective: To test the hypothesis that lung ultrasound (LUS) performed in the first week of life would predict bronchopulmonary dysplasia (BPD). Secondary outcomes included the utility of LUS in predicting interim respiratory interventions.

Design: A prospective observational cohort study in preterm infants born <28 weeks' gestation in the single tertiary statewide neonatal intensive care unit in Western Australia.

Effect of spontaneous breathing on umbilical venous blood flow and placental transfusion during delayed cord clamping in preterm lambs.

Introduction: During delayed umbilical cord clamping, the factors underpinning placental transfusion remain unknown. We hypothesised that reductions in thoracic pressure during inspiration would enhance placental transfusion in spontaneously breathing preterm lambs.

Objective: Investigate the effect of spontaneous breathing on umbilical venous flow and body weight in preterm lambs.

Postnatal cardiovascular adaptation.

The heart undergoes rapid transformations in function during the transition to extrauterine life. Our understanding of the adaptive physiology underlying this process is able to inform the clinical management of infants who are struggling to complete this complex transition. Much of our knowledge of the cardiac transition is derived from the preterm infant in whom the preparative adaptations are incomplete and clinical sequelae all too common.

Haemodynamic effects of umbilical cord milking in premature sheep during the neonatal transition.

Objective: Umbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical cord clamping (UCC) and physiological-based cord clamping (PBCC) in preterm lambs.

Methods: At 126 days' gestational age, fetal lambs were exteriorised, intubated and instrumented to measure umbilical, pulmonary and cerebral blood flows and arterial pressures.