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Regulation of the pulmonary circulation in the perinatal period and in children

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Abstract

In the fetus, the pulmonary circulation is actively maintained in a constricted state due to low oxygen environment and perhaps leukotrienes. Pulmonary blood flow represents about 8% of fetal cardiac output. Shortly after birth, pulmonary vascular resistance (PVR) and pulmonary arterial pressure fall rapidly, whereas pulmonary blood flow reaches systemic levels. The exact mechanisms by which the dramatic changes in PVR occur with the onset of ventilation at birth are extensively reviewed. They include: oxygen environment and release of vasoactive substances such as bradykinin, PGI2 or PGD2. Thus, regulation of the fetal and immediate postnatal pulmonary circulation reflects a balance between factors producing active pulmonary vasoconstriction and those producing vasodilatation.

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References

  1. Rudolph AM, Heymann MA (1970) Circulatory changes during growth in the fetal lamb. Circ Res 26:289

    Google Scholar 

  2. Heymann MA, Creasy RK, Rudolph AM (1973) Quantitation of blood flow patterns in the foetal lamb in utero. In: Comline KS, Cross KW, Dawes GS, Nathanielsz PW (eds) Foetal and neonatal-physiology. Proceedings of the Sir Joseph Barcroft Centenary Symposium, Cambridge University Press, Cambridge, pp 129–135

    Google Scholar 

  3. Kuipers JRG, Sidi D, Heymann MA, Rudolph AM (1982) Comparison of methods of measuring cardiac output in newborn lambs. Pediatr Res 16:594

    Google Scholar 

  4. Moss AJ, Emmanouilides G, Duffie ER Jr (1963) Closure of the ductus arteriosus in the newborn infant. Pediatrics 32:25

    Google Scholar 

  5. Lucas RV Jr, St Geme JW Jr, Anderson RC, Adams P Jr, Ferguson DJ (1961) Maturation of the pulmonary vascular bed: a physiologic and anatomic correlation in infants and children. Am J Dis Child 101: 467

    Google Scholar 

  6. Lewis AB, Heymann MA, Rudolph AM (1976) Gestational changes in pulmonary vascular responses in fetal lambs in utero. Circ Res 39:536

    Google Scholar 

  7. Heymann MA, Rudolph AM, Nies AS, Melmon KL (1969) Bradykinin production associated with oxygenation of the fetal lamb. Circ Res 25:521

    Google Scholar 

  8. Rudolph AM, Yuan S (1966) Response of the pulmonary vasculature to hypoxia and H+ concentration changes. J Clin Invest 45:399

    Google Scholar 

  9. Cassin S, Dawes GS, Ross BB (1964) Pulmonary blood flow and vascular resistance in immature foetal lambs. J Physiol (Lond) 171:80

    Google Scholar 

  10. Campbell AGM, Dawes GS, Fishman AP, Hyman AI (1967) Pulmonary vasoconstriction and changes in heart rate during asphyxia in immature foetal lambs. J Physiol (Lond) 192:93

    Google Scholar 

  11. McIntyre TM, Zimmerman GA, Satoh K, Prescott SM (1985) Cultured endothelial cells synthesize both platelet-activating factor and prostacyclin in response to histamine, bradykinin, and adenosine triphosphate. J Clin Invest 76:271

    Google Scholar 

  12. Cassin S, Dawes GS, Mott JC, Ross BB, Strang LB (1964) The vascular resistance of the foetal and newly ventilated lung of the lamb. J Physiol (Lond) 171:61

    Google Scholar 

  13. Cassin S (1980) Role of prostaglandins and thromboxanes in the control of the pulmonary circulation in the fetus and newborn. Semin Perinatol 4:101

    Google Scholar 

  14. Gryglewski RJ (1980) The lung as a generator of prostacyclin. Ciba Found Symp 78:147

    Google Scholar 

  15. Leffler CW, Hessler JR, Green RS (1984) Mechanism of stimulation of pulmonary prostaglandin synthesis at birth. Prostaglandins 28:877

    Google Scholar 

  16. Omini C, Vigano T, Marini A, Pasargiklian R, Fano M, Maselli MA (1983) Angiotensin II: a releaser of PGI2 from fetal and newborn rabbit lungs. Prostaglandins 25:901

    Google Scholar 

  17. VanGrondelle A, Worthen S, Ellis D, Mathias MM, Murphy RC, Murphy RJ, Strife J, Reeves JT, Voelkel NF (1984) Altering hydrodynamic variables influences PGI2 production by isolated lungs and endothelial cells. J Appl Physiol 57:388

    Google Scholar 

  18. Soifer SJ, Morin FC III, Kaslow DC, Heymann MA (1983) The developmental effects of PGD2 on the pulmonary and systemic circulations in the newborn lamb. J Dev Physiol 5:237

    Google Scholar 

  19. Schwartz LW, Osburn BI, Frick OL (1974) An ontogenic study of histamine and mast cells in the fetal rhesus monkey. J Allergy Clin Immunol 56:381

    Google Scholar 

  20. Leffler CW, Tyler TL, Cassin S (1978) Effects of indomethacin on pulmonary vascular response to ventilation of fetal goats. Am J Physiol 234:H346

    Google Scholar 

  21. Voelkel NF, Chang SW, Pfeffer KD, Worthen SG, McMurtry IF, Henson PM (1986) PAF antagonists: different effects on platelets, neutrophils, guinea pig ileum and PAF-induced vasodilation in isolated rat lung. Prostaglandins 32:359

    Google Scholar 

  22. Soifer SJ, Loitz RD, Roman C, Heymann MA (1985) Leukotriene end organ antagonists increase pulmonary blood flow in fetal lambs. Am J Physiol 249:H570

    Google Scholar 

  23. Voelkel NF (1986) Mechanisms of hypoxic pulmonary vasoconstriction. Am Rev Respir Dis 133:1186

    Google Scholar 

  24. Rojas J, Larsson LE, Ogletree ML, Brigham KL, Stahlman MT (1983) Effects of cyclooxygenase inhibition on the response to group B streptococcal toxin in sheep. Pediatr Res 17:107

    Google Scholar 

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Authors and Affiliations

  1. Cardiovascular Research Institute, University of California, San Francisco, USA

    M. A. Heymann

  2. Department of Pediatrics, University of California, San Francisco, USA

    M. A. Heymann

  3. Department of Physiology, University of California, San Francisco, USA

    M. A. Heymann

  4. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA

    M. A. Heymann

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  1. M. A. Heymann
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Heymann, M.A. Regulation of the pulmonary circulation in the perinatal period and in children. Intensive Care Med 15 (Suppl 1), S9–S12 (1989). https://doi.org/10.1007/BF00260875

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  • DOI: https://doi.org/10.1007/BF00260875

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