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Biomedical subjects

R Harding

Publications and source records attributed to R Harding.

At least 55 records · Page 3Linked to original sources

Arousal and cardiorespiratory responses to airflow obstruction in sleeping lambs: effects of sleep state, age, and repeated obstruction.

We studied the effects of postnatal age on arousal and cardiorespiratory responses to airflow obstruction in sleeping lambs: we also determined the influence of sleep states and repeated airflow obstruction. Sixteen lambs were chronically prepared for monitoring sleep states, arterial O2 saturation (SaO2), heart rate (HR), and intrapleural pressure (Pp1) and were studied from 2-29 days after birth. Obstruction of respiratory airflow by facemask occlusion led to arterial desaturation, augmentation of respiratory efforts, bradycardia, and arousal. Lambs aroused more rapidly and with less desaturation in non-rapid eye movement (NREM) sleep (7 +/- 1 second and 7 +/- 1%, respectively) than in rapid eye movement (REM) sleep (18 +/- 2 seconds and 22 +/- 2%), and cardiac slowing was less in NREM than in REM sleep. In REM sleep only, the arousal latency and desaturation at arousal were affected by postnatal age; arousal responses occurred most rapidly in the youngest (< or = 6 days) and oldest (> or = 13 days) age groups and were delayed at 7-12 days. Repeated episodes of airflow obstruction led to reduced arousability in REM sleep only. We conclude that arousal from REM. but not NREM, sleep in response to the obstruction of respiratory airflow is transiently depressed during early postnatal development and that repeated obstructions and arousals also lead to depressed arousal from REM sleep.

Age Factors↗

Fetal pulmonary development: the role of respiratory movements.

The lung develops before birth as a collapsible, liquid-filled, organ. Throughout the later stages of gestation the fetal lungs are maintained at a level of expansion that is considerably greater than the level achieved as a result of passive equilibration between lung recoil and the chest wall. Fetal breathing movements (FBM) are a feature of normal fetal life and, as such, are used clinically in the assessment of fetal wellbeing. By opposing lung recoil, FBM help to maintain the high level of lung expansion that is now known to be essential for normal growth and structural maturation of the fetal lungs. During 'apnoeic' periods between successive episodes of FBM, active laryngeal constriction has the effect of opposing lung recoil by resisting the escape of lung liquid via the trachea. The prolonged absence or impairment of FBM is likely to result in a reduced mean level of lung expansion which can lead to hypoplasia of the lungs. There is clinical evidence, disputed by some, that the absence of FBM exacerbates the effects of other factors that are associated with lung hypoplasia, such as premature rupture of fetal membranes and oligohydramnios. Even in the absence of such factors, prolonged or repeated reductions or abolition of FBM may contribute to impairments of fetal lung development; FBM can be inhibited by fetal hypoxaemia, hypoglycaemia, maternal alcohol consumption, maternal smoking, intra-amniotic infection and maternal consumption of sedatives or narcotic drugs. Abnormal growth of the fetal lungs has relevance for postnatal respiratory health as it is now recognised that there may be only a limited capacity after birth for the restoration of normal pulmonary architecture following impaired intra-uterine lung development.

Animals↗

Fetal and maternal fluid balance in sheep during hyperthermia with and without water deprivation.

Our aim was to determine the effect of maternal hyperthermia, both with and without maternal water deprivation, on fetal fluid balance. Seven pregnant ewes (131.8 +/- 1.0 days gestation) were studied during a control period and periods of maternal heating (MH, 42-44 degrees C for 8 h, water freely available), maternal water deprivation (MWD, 30 h) and maternal heating combined with water deprivation (MH + MWD, 30 h deprivation with heating during last 8 h). Relative to control values, MH increased maternal water intake and urine output, and [K+] in fetal plasma and fetal urine. Relative to control values, MH decreased maternal plasma osmolality, [Na+] and [K+]; fetal plasma osmolality and [Na+]; fetal lung liquid [Na+] and [Cl-]; and fetal production rates of lung liquid and urine. In response to MH + MWD, the osmolality, [Na+] and [Cl-] of maternal and fetal plasma, fetal lung liquid and fetal urine (excluding urinary [Cl-]) increased compared with control values. In the fetus, MH + MWD increased plasma and urinary [K+], and decreased production rates of lung liquid and urine compared with control values. During MH + MWD, compared with MH alone, greater alterations were seen in maternal rectal temperature, water input and urine output; osmolality, [Na+] and [Cl-] of maternal and fetal plasma, fetal lung liquid and fetal urine (excluding urinary [Cl-]); and fetal urinary [K+]. During MH + MWD, compared with MWD alone, greater alterations were seen in maternal plasma [Cl-] and [K+]; fetal urinary osmolality and [K+]; and fetal plasma [K+]. Our results show that, when water is available, maternal hyperthermia stimulates ewes to drink substantially more than under normal conditions, thereby decreasing their plasma osmolality; water transfer to the fetus may increase, thereby decreasing fetal plasma osmolality. When drinking water is unavailable, maternal hyperthermia and associated dehydration may decrease water transfer to the fetus. Thus, the fetus becomes not only hyperthermic, but also hyperosmotic and possibly hypovolaemic. Maternal hyperthermia, irrespective of the availability of drinking water, decreases production rates of lung liquid and urine in the fetus.

Animals↗

Renal and amniotic fluid responses to umbilicoplacental embolization for 20 days in fetal sheep.

We determined the effects of placental insufficiency induced by umbilicoplacental embolization on fetal renal function and amniotic fluid volume and composition. Pregnant ewes underwent surgery at 115 +/- 2 days after mating (term approximately 147 days) for implantation of fetal vascular, bladder, and amniotic sac catheters. We studied five fetuses from 120 to 140 days during umbilicoplacental embolization and six control fetuses. Umbilicoplacental embolization reduced fetal arterial partial pressure of oxygen from 24.1 +/- 0.5 mmHg (pretreatment) to 14.6 +/- 0.2 mmHg. Fetal body weights were reduced to 80% of control values. Urine production and glomerular filtration rate in treated fetuses were significantly lower than in controls at 135 days of gestation. Amniotic fluid volume was not different between embolized and control animals. Fetal urine production in treated fetuses, when adjusted for body weight, was not different from that in control fetuses. We conclude that, in fetal growth restriction, reduced kidney weight, rather than hypoxemia per se is responsible for reduced urine production, which, if severe and prolonged, may contribute to oligohydramnios.

Amnion↗

Lung liquid production rates and volumes do not decrease before labor in healthy fetal sheep.

Previous studies have suggested that the volume and production rate of fetal lung liquid decrease late in gestation, before the onset of labor, in preparation for the clearance of lung liquid at birth. In contrast, our earlier studies have not shown a decrease in lung liquid volume near term, although these studies were not continued to the onset of labor. Our aim was to determine the changes in lung liquid volume and production rate in fetal sheep during the last 2 wk of gestation up to the onset of labor at term (approximately 147 days). In eight chronically catheterized fetal sheep, the volume and production rate of fetal lung liquid were measured at 130, 135, and 140 days of gestation and then on every 2nd day until the onset of labor. Labor was detected by monitoring uterine muscle activity and intrauterine pressure changes. On the day of labor onset, which occurred at 147 +/- 1 days of gestation, fetuses weighted 5.0 +/- 0.2 kg. The volume of fetal lung liquid was 40.4 +/- 2.7 ml/kg at 19 +/- 1 days before labor onset and had not significantly changed by 0.7 +/- 0.2 days (44.8 +/- 5.1 ml/kg) before labor. Similarly, lung liquid production rates at 19 +/- 1 days before labor (5.1 +/- 1.8 ml.h-1.kg-1) were not significantly different from those at 0.7 +/- 0.2 days before labor (3.4 +/- 0.7 ml.h-1.kg-1). We conclude that, in healthy ovine fetuses, lung liquid volumes and production rates do not decrease before the onset of labor. Our results indicate that the entire volume of fetal lung liquid (approximately 222.5 +/- 36.6 ml) must be cleared after the onset of labor.

Animals↗

Cerebral oxygen delivery is reduced during the acidaemia associated with prolonged hypoxaemia in the immature ovine fetus.

Our aim was to determine the effects of 12 h of hypoxaemia on cerebral blood flow (CBF) and cerebral O2 delivery in ovine fetuses at 0.6 gestation. During fetal hypoxaemia, induced by reduced uterine blood flow, fetal SaO2 and PaO2 were reduced (p < 0.01) from control values of 77.0 +/- 1.6% and 27.3 +/- 1.0 mm Hg, respectively, to 28.4 +/- 3.4% and 15.6 +/- 0.6 mm Hg; fetal pHa decreased from control values of 7.37 +/- 0.01 to 7.20 +/- 0.02 at 3 h, but returned to control values before 12 h. CBF (ml/min/100 g) was 2.0- to 2.6-fold higher (p < 0.01) than control values during hypoxaemia, but only 1.7-fold higher (p < 0.01) at 3 h when pHa was lowest. Cerebral O2 delivery (ml/min/100 g) was lower (p < 0.01) than control values of 3.15 +/- 0.29 at 1.5h (2.09 +/- 0.36) and 3h (1.84 +/- 0.22) of hypoxaemia and higher 1 h after hypoxaemia had ceased (3.81 +/- 0.22, p < 0.01). We conclude that the ovine fetus at 0.6 gestation is unable to sustain increased CBF and hence maintain cerebral O2 delivery during the first 6 h of hypoxaemia, a time which coincides with acidaemia; in contrast, at 6 and 12 h of hypoxaemia, when pHa was normal, cerebral O2 delivery was similar to control values. Reduced cerebral O2 delivery during the early, acidaemic, stages of hypoxaemia may lead to impaired neural development.

Acidosis↗

Limited spatial clustering of individual Plasmodium falciparum alleles in field isolates from coastal Kenya.

We describe Plasmodium falciparum genetic diversity in coastal Kenya, typing S-antigen and the merozoite surface proteins 1 and 2 (MSP-1 and MSP-2) in field isolates by the polymerase chain reaction (PCR). Malaria in coastal Kenya is characterized by low seasonal transmission, and a relatively high incidence of severe disease, which tends to occur in time-space clusters. We chose the highly polymorphic S-antigen as a marker for localized parasite diversity because it has been shown to vary in serotype prevalence in time and space. A total of 261 children (up to nine years of age) in two neighboring locations with different transmission rates were sampled for blood-stage parasites in cross-sectional surveys before and after the main transmission period in 1991, and also in a concomitant one-year longitudinal survey tracing clinical infections. Six major sequence types of S-antigen were identified, which were subdivided into 70 alleles; however, only 50% of isolates were typeable. The S-antigen sequence types varied qualitatively between locations, over time, and between asymptomatic and clinical disease infections, but not between different age groups. The MSP-1 and MSP-2 sequence type prevalences, in contrast, did not differ in any of these comparisons. We describe the use of the Mantel test for assessing clustering of individual parasite alleles at the household level, and demonstrate low-level clustering of MSP-1 and MSP-2 alleles and S-antigen sequence types, at the end of a long period of low transmission.

Age Factors↗

Prematurity alters hypoxic and hypercapnic ventilatory responses in developing lambs.

We have determined the effects of preterm birth on the postnatal development of ventilatory responses to progressive hypoxia and hypercapnia in awake lambs. Hypoxic and hypercapnic rebreathing tests were performed at weekly intervals in 5 preterm (born at 135 +/- 0.5 d) and 5 term (born at 146 +/- 0.2 d) lambs up to 6-7 weeks after birth. Term lambs were also studied at 25 weeks after birth. During rebreathing tests, we measured arterial PO2 and PCO2 and related them to minute ventilation (VI). Owing to variability in resting PAO2, hypoxic sensitivity was defined as the percentage increase in VI when PaO2 fell to 60% of resting values. Hypoxic sensitivities of preterm lambs did not change with age (68.9 +/- 24.4%), whereas values for term lambs more than doubled over the first 6 weeks (day 2, 73.9 +/- 15.8%; week 6, 227.4 +/- 24.9%) but returned to early postnatal values by week 25 (87.0 +/- 21.2%). Hypercapnic sensitivities (ml min-1 kg-1 mmHg CO2(-1) of preterm lambs were lower than those of term lambs between day 2 and week 2, but reached values in term lambs thereafter. We conclude that preterm birth abolishes the normal postnatal maturation of hypoxic ventilatory sensitivity, and temporarily depresses hypercapnic sensitivity.

Animals↗

Changes in thoracic dimensions induced by breathing movements in fetal sheep.

The dimensions of the three major axes of the thorax (longitudinal, transverse and antero-posterior) were monitored in utero from the ultrasonic transit-time between pairs of piezo-electric transducers chronically implanted at opposite sides of the thorax in five fetal sheep at 119-122 days of gestation; tracheal and vascular catheters and diaphragmatic EMG electrodes were also implanted. To measure thoracic length, ultrasound transducers were implanted on the diaphragm and over the upper sternum and manubrium sterni. A pair was implanted on opposite sides of the chest to measure thoracic width, and another pair was implanted over the lower thoracic spine and lower sternum (antero-posterior dimension). The width of the thorax either decreased (mean 0.6 +/- 0.2 mm) or increased (mean 0.7 +/- 0.1 mm) during fetal breathing movements (FBM). The depth of the thorax (antero-posterior dimension) usually decreased (mean 0.9 +/- 0.1 mm) during FBM. The distance between the upper sternum and the diaphragm decreased by 1.0 +/- 0.1 mm (left side) and 1.6 +/- 0.3 mm (right side) during inspiratory efforts. The distance between the upper thorax and a fixed point on the lower thoracic spine decreased by a similar amount. Overall, fetal thoracic dimensions changed by 1-3%. The largest changes measured, and the most surprising, were reductions, rather than increases, in the separation between the dome of the diaphragm and the upper thorax; this suggests that, during inspiratory efforts, the upper thorax moves caudally by a greater distance than the diaphragm. FBM induce complex and variable changes in thoracic dimensions; these are likely to induce small alterations in the shape of the lungs that may act as a stimulus to lung growth.

Animals↗

Acidaemia enhances the inhibitory effect of hypoxia on fetal lung liquid secretion in sheep.

Previous studies have shown that moderate fetal asphyxia reduces the secretion rate of fetal lung liquid. The present aim was to determine the relative effects of the individual components of asphyxia (hypoxia, hypercapnia and acidaemia) on lung liquid secretion in fetal sheep. Fetal hyperoxia was also studied to determine the extent to which lung liquid secretion is restricted by the relatively low fetal blood PO2. As each manipulation of fetal blood gas tensions and pH treatment produced alterations in more than one aspect of blood composition, data from all treatment groups were combined and a multiple analysis of variance was performed to determine the separate effects of PaO2, PaCO2, SaO2 and pHa. Lung liquid secretion rate was significantly reduced when mean PaO2 values were below 24.5 mmHg (range 12.9-24.3 mmHg). When PaO2 values below 24.5 mmHg occurred in combination with pHa values below 7.275 (range 6.934-7.268) the secretion rates were further reduced. Alterations in pHa alone or in PaCO2 had no significant effect. These results indicate that hypoxia is the principal factor responsible for the inhibition of lung liquid secretion during asphyxia and that acidaemia enhances this inhibition.

Acids↗

Alterations in fetal urine production during prolonged hypoxaemia induced by reduced uterine blood flow in sheep: mechanisms.

1. Our aim was to identify mechanisms whereby prolonged fetal hypoxaemia alters renal function and urine production in fetal sheep. 2. Fetal hypoxaemia was induced for 24 h by reducing uterine blood flow at 129.0 +/- 2.1 days of gestation (term 145-147 days), causing a reduction in fetal arterial O2 saturation (SaO2) from 52.5 +/- 2.3 to 22.0 +/- 1.3% (P < 0.05). This hypoxaemia was initially associated with a mild acidaemia (pH 7.23 +/- 0.03). 3. The glomerular filtration rate (GFR) increased from a control value of 1.8 +/- 0.3 mL/min per kg to a maximal value of 2.8 +/- 0.6 mL/min per kg (P < 0.05) at 4-5 h of hypoxaemia, returning to control levels by 6-9 h of hypoxaemia. After 4 h of hypoxaemia renal blood flow was no different to control values (144 +/- 8 mL/min per 100 g kidney weight) but after 24 h of hypoxaemia it had increased to 190 +/- 8 mL/min per 100 g kidney weight (P < 0.05). Fractional reabsorption of Na+ in the proximal tubules decreased from a control value of 81.5 +/- 2.2 to 65.2 +/- 3.9% at 2-3 h of hypoxaemia (P < 0.05) and remained reduced (68.5 +/- 3.1%) at the end of hypoxaemia (P < 0.05). Fetal mean arterial pressure transiently increased (P < 0.05) but returned to control values by 4-5 h of hypoxaemia. Fetal renal vascular resistance was not significantly altered during hypoxaemia. Fetal urine production increased from a control value of 12.3 +/- 2.1 mL/h per kg to a maximal value of 19.1 +/- 4.2 mL/h per kg at 4-5 h of hypoxaemia (P < 0.05) and returned to control by 24 h of hypoxaemia. 4. Our results indicated that prolonged fetal hypoxaemia leads to the inhibition of Na+ reabsorption in the proximal portion of the renal tubules. Changes in GFR induced by hypoxaemia were similar to those in fetal urine production and were not associated with changes in renal blood flow. We conclude that prolonged fetal hypoxaemia affects renal haemodynamics and the reabsorptive capacity of the renal tubules, resulting in a diuresis.

Animals↗

Role of the adrenal glands in the maturation of lung liquid secretory mechanisms in fetal sheep.

Our aim was to determine the role of the fetal adrenal glands in the gestational age-related increase in the ability of epinephrine to induce the reabsorption of lung liquid. Fetal lung liquid volumes and secretion rates were measured in five chronically catheterized control and six bilaterally adrenalectomized (ADX) fetal sheep at approximately 5-day intervals from 120 to 144 days of gestation (term approximately 146 days). The ability of epinephrine to induce the reabsorption of fetal lung liquid was then determined on day 144. Fetal adrenalectomy prevented the preparturient increase in fetal plasma cortisol and 3,5,3'-triiodothyronine (T3) concentration and significantly reduced the gestational age-related increase in fetal lung liquid volumes and secretion rates. Close to term (144 days), epinephrine infusions caused a significantly greater rate of lung liquid reabsorption in control (32.2 +/- 4.8 ml/h) compared with ADX (3.7 +/- 0.7 ml/h) fetuses. We conclude that the presence of the fetal adrenal glands is necessary for the age-related increase in 1) the lung liquid secretion rate and 2) the ability of the fetal lung to reabsorb liquid late in gestation. It is likely that cortisol is the active adrenal hormone involved, supporting the theory that cortisol plays a crucial role in the clearance of lung liquid at birth.

Adrenal Glands↗

Regulation of lung expansion and lung growth before birth.

Fetal lung growth depends on the degree to which lungs are distended with luminal liquid. Fetal lungs are highly distended such that mean luminal volume exceeds the static relaxation volume. This high level of expansion is maintained by fetal breathing movements and by resistive effects of the upper airway during apnea; both factors oppose lung recoil. Mechanical stress in lung and other tissues stimulates cell division and tissue remodeling. Potential transduction mechanisms involve direct effects of cellular tension and mediation of locally released mitogenic factors. Further studies are required to further define links between lung tissue stress, increased growth, structural remodeling, and the endocrine environment. A common cause of fetal lung hypoplasia is a sustained reduction in mean lung expansion. Studies of mechanisms controlling fetal lung expansion have led to insights into the etiology of fetal lung hypoplasia and how it may be remedied in utero. Fetal lung hypoplasia can have long-lasting effects on postnatal lung function, as airway and alveolar formation may be compromised. Preterm birth may also result in incomplete structural development of the lungs as it shortens the period of increased intrauterine lung expansion.

Animals↗

Development of ventilatory responsiveness to progressive hypoxia and hypercapnia in low-birth-weight lambs.

Our aim was to determine the effects of low birth weight on ventilatory responses to progressive hypoxia and hypercapnia during early postnatal life. Seven low-birth-weight (2.7 +/- 0.3 kg) and five normal-birth-weight (4.8 +/- 0.2 kg) lambs, all born at term, underwent weekly rebreathing tests during wakefulness while arterial PO2, PCO2, and pH were measured. Hypoxic ventilatory responsiveness (HOVR; percent increase in ventilation when arterial PO2 fell to 605 of resting values) increased in normal lambs from 86.6 +/- 7.1% at week 1 to 227.4 +/- 24.9% at week 6. In low-birth-weight lambs, HOVR was not significantly different at week 1 (60.1 +/- 18.7%) from that of normal lambs but did not increase with postnatal age (56.6 +/- 19.3% at week 6). HOVR of all lambs at 6 wk was significantly correlated with birth weight (r2 = 0.8). Hypercapnic ventilatory responsiveness (gradient of ventilation vs. arterial PCO2) did not change with age and was not significantly different between groups [84.7 +/- 7.5 (low-birth-weight lambs) vs. 89.4 +/- 6.6 ml.min-1.kg-1.mmHg-1 (normal lambs)]. We conclude that intrauterine conditions that impair fetal growth lead to the failure of HOVR to increase with age.

Aging↗

Influence of sedation on arousal and cardiorespiratory responses to airflow obstruction in sleeping lambs.

Our aim was to determine the effects of two commonly used sedatives, promethazine and diazepam, on arousal and cardiorespiratory responses to airflow obstruction in sleeping lambs. In eight lambs fitted with obstructable rubber face masks, we recorded electrocortical, electroocular, and electromyographic activities to identify sleep-wake states; intrapleural pressure, heart rate, and percentage O2 saturation (Sao2) were also recorded. In each lamb, arousal and respiratory responses were measured after tidal airflow was obstructed during rapid eye movement (REM) and nonREM sleep. Each lamb was studied, on different days, when unsedated and after being mildly sedated with either promethazine or diazepam. Seven of the lambs were studied while sleeping after being sedated with promethazine (1.6 +/- 0.07 mg/kg, orally with milk) and six were studied after sedation with diazepam (0.31 +/- 0.03 mg/kg, intramuscularly). In unsedated lambs, airflow obstruction led to augmentation of respiratory efforts, bradycardia, hypoxemia, and arousal; in REM sleep, arousal was delayed and occurred at lower Sao2 (16 +/- 3 s; 75.3 +/- 3%) compared with nonREM sleep (8 +/- 1 s; 90 +/- 1%). Sedation increased the arousal latency in both REM and nonREM sleep and caused arousal to occur at lower Sao2; in some sedated lambs Sao2 fell to less than 30% before arousal. The augmentation of inspiratory and expiratory efforts immediately before arousal was increased after sedation. We conclude that promethazine and diazepam depress arousal responses in sleeping lambs leading to profound hypoxia, and that this may be due to impaired sensitivity to augmented respiratory efforts and other physiologic changes during airflow obstruction.

Animals↗