کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
10431370 910212 2015 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Transition from fetal to neonatal circulation: Modeling the effect of umbilical cord clamping
ترجمه فارسی عنوان
انتقال از جنین به گردش خون نوزاد: مدل سازی اثر بستن بند ناف
کلمات کلیدی
همودینامیک جنینی، انتقال جنین به نوزادان، بستن بند ناف، بستن کرنپل بند ناف تاخیری مدل پارامتر لمسی دینامیک قلب و عروق،
موضوعات مرتبط
مهندسی و علوم پایه سایر رشته های مهندسی مهندسی پزشکی
چکیده انگلیسی
Hemodynamics of the fetal to neonatal transition are orchestrated through complex physiological changes and results in cardiovascular adaptation to the adult biventricular circulation. Clinical practice during this critical period can influence vital organ physiology for normal newborns, premature babies and congenital heart defect patients. Particularly, the timing of the cord clamping procedure, immediate (ICC) vs. delayed cord clamping (DCC), is hypothesized to be an important factor for the transitory fetal hemodynamics. The clinical need for a quantitative understanding of this physiology motivated the development of a lumped parameter model (LPM) of the fetal cardio-respiratory system covering the late-gestation to neonatal period. The LPM was validated with in vivo clinical data and then used to predict the effects of cord clamping procedures on hemodynamics and vital gases. Clinical time-dependent resistance functions to simulate the vascular changes were introduced. For DCC, placental transfusion (31.3 ml) increased neonatal blood volume by 11.7%. This increased blood volume is reflected in an increase in preload pressures by ~20% compared to ICC, which in turn increased the cardiac output (CO) by 20% (COICC=993 ml/min; CODCC=1197 ml/min). Our model accurately predicted dynamic flow patterns in vivo. DCC was shown to maintain oxygenation if the onset of pulmonary respiration was delayed or impaired. On the other hand, a significant 25% decrease in oxygen saturations was observed when applying ICC under the same physiological conditions. We conclude that DCC has a significant impact on newborn hemodynamics, mainly because of the improved blood volume and the sustained placental respiration.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Biomechanics - Volume 48, Issue 9, 25 June 2015, Pages 1662-1670
نویسندگان
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