Control of the Pulmonary Circulation in the Perinatal Period

  • M. A. Heymann
Conference paper

Abstract

In the fetus, gas exchange occurs in0 the placenta and pulmonary blood flow requirements are therefore low. In the undisturbed near-term fetal lamb (the species in which accurate measurements have been made), pulmonary blood flow is 90–110 ml min-1 100 g-1 wet lung tissue or 30–40 ml min-1 kg-1 fetal body weight. This represents about 8% of total fetal cardiac output, which near term is normally about 450 ml min-1 kg-1 fetal body weight (Rudolph and Heymann 1970; Heymann et al. 1973). The low pulmonary blood flow at this stage of gestation is maintained by a high pulmonary vascular resistance. Shortly after birth, with the initiation of pulmonary ventilation, pulmonary vascular resistance and pulmonary arterial pressure fall rapidly. There is an associated eight- to ten-fold increase in pulmonary blood flow, which in lambs reaches 300–400 ml min-1 kg-1 body weight shortly after birth (Kuipers et al. 1982). In the sheep, pulmonary arterial blood pressure falls towards adult levels within several hours; however, in humans at 24 h of age, normal mean pulmonary arterial blood pressure may still be about twice normal adult levels (Moss et al. 1963). After the initial quite rapid fall in pulmonary vascular resistance and pulmonary arterial blood pressure, there is a slow progressive fall to near-adult levels by 3–6 weeks after birth (Lucas et al. 1961) related to growth of new vessels, to the involution of the large amount of medial smooth muscle found normally in the small pulmonary arteries in the fetus, and also possibly to changes in viscosity as hematocrit falls.

Keywords

Adenosine Angiotensin Histamine Prostaglandin Resis 

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References

  1. 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: 93–110Google Scholar
  2. Cassin S (1980) Role of prostaglandins and thromboxanes in the control of the pulmonary circulation of the fetus and newborn. Semin Perinatol 4:101–107PubMedGoogle Scholar
  3. Cassin S, Dawes GS, Mott JC, Ross BB, Strang LB (1964 a) The vascular resistance of the foetal and newly ventilated lung of the lamb. J Physiol (Lond) 171: 61–79Google Scholar
  4. Cassin S, Dawes GS, Ross BB (1964b) Pulmonary blood flow and vascular resistance in immature foetal lambs. J Physiol (Lond) 171: 80–89Google Scholar
  5. Cassin S, Tyler TL, Leffler C, Wallis R (1979) Pulmonary and systemic vascular responses of perinatal goats to prostaglandin E1 and E2. Am J Physiol 236: H828–H832PubMedGoogle Scholar
  6. Cassin S, Winikor I, Tod M, Philips J, Frisinger S, Jordan J, Gibbs C (1981) Effects of prostacyclin on the fetal pulmonary circulation. Pediatr Pharmacol (New York) 1:197–207Google Scholar
  7. Clozel M, Clyman RJ, Soifer SJ, Heymann MA (1985) Thromboxane is not responsible for the high pulmonary vascular resistance in fetal lambs. Pediatr Res 19:1254–1257PubMedCrossRefGoogle Scholar
  8. Dusting AJ (1981) Angiotensin-induced release of a prostacyclin-like substance from the lungs. J Cardiovasc Pharmacol 3:197–206PubMedCrossRefGoogle Scholar
  9. Enhorning G, Adams FH, Norman A (1966) Effect of lung expansion on the fetal lamb circulation. Acta Paediatr Scand 55: 441–451PubMedCrossRefGoogle Scholar
  10. Goetzman BW, Milstein JM (1980) Pulmonary vascular histamine receptors in newborn and young lambs. J Appl Physiol 49: 380–385PubMedGoogle Scholar
  11. Gryglewski RJ (1980) The lung as a generator of prostacyclin. Ciba Found Symp 78:147–164PubMedGoogle Scholar
  12. Gryglewski RJ, Korbut R, Ocetkiewicz A (1978) Generation of prostacyclin by lungs in vivo and its release into the arterial circulation. Nature 273: 765–767PubMedCrossRefGoogle Scholar
  13. Heymann MA, Rudolph AM, Nies AS, Melmon KL (1969) Bradykinin production associated with oxygenation of the fetal lamb. Circ Res 25: 521–534PubMedGoogle Scholar
  14. 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) Proceedings of the Sir Joseph Barcroft Centenary Symposium. Foetal and Neonatal Physiology. Cambridge University Press, Cambridge, pp 129–135Google Scholar
  15. Kuipers JRG, Sidi D, Heymann MA, Rudolph AM (1982) Comparison of methods of measuring cardiac output in newborn lambs. Pediatr Res 16: 594–598PubMedCrossRefGoogle Scholar
  16. LeBidois J, Soifer SJ, Clyman RI, Heymann MA (1987) Piriprost, a putative leukotriene inhibitor, increases pulmonary blood flow in fetal lambs. Pediatr Res 22: 350–354PubMedCrossRefGoogle Scholar
  17. Leffler CW, Hessler JR (1979) Pulmonary and systemic vascular effects of exogenous prostaglandin I2 in fetal lambs. Eur J Pharmacol 54: 37–42PubMedCrossRefGoogle Scholar
  18. Leffler CW, Tyler TL, Cassin S (1978) Effect of indomethacin on pulmonary vascular response to ventilation of fetal goats. Am J Physiol 234: H346–H351PubMedGoogle Scholar
  19. Leffler CW, Hessler JR, Terragno NA (1980) Ventilation-induced release of prostaglandin-like material from fetal lungs. Am J Physiol 238: H282-H286PubMedGoogle Scholar
  20. Leffler CW, Hessler JR, Green RS (1984a) Mechanism of stimulation of pulmonary prostaglandin synthesis at birth. Prostaglandins 28: 877–887PubMedCrossRefGoogle Scholar
  21. Leffler CW, Hessler JR, Green RS (1984b). The onset of breathing at birth stimulates pulmonary vascular prostacyclin synthesis. Pediatr Res 18: 938–942PubMedGoogle Scholar
  22. Lewis AB, Heymann MA, Rudolph AM (1976) Gestational changes in pulmonary vascular responses in fetal lambs in utero. Circ Res 39: 536–541PubMedGoogle Scholar
  23. Lucas RV Jr, St Gerne 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: 467–475Google Scholar
  24. 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: 271–280PubMedCrossRefGoogle Scholar
  25. Moss AJ, Emmanouilides G, Duffie ER Jr (1963) Closure of the ductus arteriosus in the newborn infant. Pediatrics 32: 25–30PubMedGoogle Scholar
  26. 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: 901–910PubMedCrossRefGoogle Scholar
  27. Rudolph AM, Heymann MA (1970) Circulatory changes during growth in the fetal lamb. Circ Res 26: 289–299PubMedGoogle Scholar
  28. Rudolph AM, Yuan S (1966) Response of the pulmonary vasculature to hypoxia and H+ ion concentration changes. J Clin Invest 45: 399–411PubMedCrossRefGoogle Scholar
  29. 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: 381–386CrossRefGoogle Scholar
  30. Soifer SJ, Morin FC III, Kaslow DC, Heymann MA (1983) The development effects of PGD2 on the pulmonary and systemic circulations in the newborn lamb. J Dev Physiol 5: 237–250PubMedGoogle Scholar
  31. 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–H576PubMedGoogle Scholar
  32. 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: 388–395Google Scholar
  33. 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: 359–372PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • M. A. Heymann
    • 1
  1. 1.Cardiovascular Research Institute and Department of Pediatrics, Department of Physiology, and Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of CaliforniaSan FranciscoUSA

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