{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:48:09Z","timestamp":1792705689626,"version":"4.5.0"},"reference-count":40,"publisher":"American Physiological Society","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p>\n                    In mature lungs, elevated positive end-expiratory pressure (PEEP) reduces pulmonary blood flow (PBF) and increases pulmonary vascular resistance (PVR). However, the effect of PEEP on PBF in preterm infants with immature lungs and a patent ductus arteriosus is unknown. Fetal sheep were catheterized at 124 days of gestation (term \u223c147 days), and a flow probe was placed around the left pulmonary artery to measure PBF. At 127 days, lambs were delivered and ventilated from birth with a tidal volume of 5 ml\/kg and 4-cmH\n                    <jats:sub>2<\/jats:sub>\n                    O PEEP; PEEP was changed to 0, 8, and 12 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O in random order, returning to 4 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O between each change. Increasing PEEP from 4 to 8 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O and from 4 to 12 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O decreased PBF by 20.5 and 41.0%, respectively, and caused corresponding changes in PVR; reducing PEEP from 4 to 0 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O did not affect PBF. Despite decreasing PBF, increasing PEEP from 4 to 8 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O and 12 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O improved oxygenation of lambs. Increasing and decreasing PEEP from 4 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O significantly changed the contour of the PBF waveform; at a PEEP of 12 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O, end-diastolic flow was reduced by 82.8% and retrograde flow was reestablished. Although increasing PEEP improves oxygenation, it adversely affects PBF and PVR shortly after birth, alters the PBF waveform, and reestablishes retrograde flow during diastole.\n                  <\/jats:p>","DOI":"10.1152\/japplphysiol.00055.2005","type":"journal-article","created":{"date-parts":[[2005,5,12]],"date-time":"2005-05-12T20:24:51Z","timestamp":1115929491000},"page":"1453-1461","source":"Crossref","is-referenced-by-count":92,"title":["Positive end-expiratory pressure differentially alters pulmonary hemodynamics and oxygenation in ventilated, very premature lambs"],"prefix":"10.1152","volume":"99","author":[{"given":"Graeme R.","family":"Polglase","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin J.","family":"Morley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J.","family":"Crossley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Dargaville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Harding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart B.","family":"Hooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1092010410"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.1.112"},{"key":"R3","unstructured":"Friedman AH\n                      and Fahey JT.\n                      The transition from fetal to neonatal circulation: normal responses and implications for infants with heart disease.\n                      Semin Perinatol\n                      17\n                      : 106\u2013121, 1993."},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1984.56.5.1439"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.60.1.114"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1989.66.2.660"},{"key":"R7","unstructured":"Gecelovska V\n                      and Javorka K.\n                      Cardiovascular and haemodynamic changes during artificial ventilation of the lungs.\n                      Bratisl Lek Listy\n                      97\n                      : 260\u2013266, 1996."},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-097X.1985.tb00601.x"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1969.26.1.65"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1999.87.5.1637"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1979.47.5.938"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.61.3.819"},{"key":"R13","unstructured":"Heymann MA\n                      .\n                      Control of the pulmonary circulation in the perinatal period.\n                      J Dev Physiol\n                      6\n                      : 281\u2013290, 1984."},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Heymann MA\n                      .\n                      Control of the pulmonary circulation in the fetus and during the transitional period to air breathing.\n                      Obstet Gynecol\n                      84\n                      : 127\u2013132, 1999.","DOI":"10.1016\/S0301-2115(98)00321-2"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1113\/expphysiol.1998.sp004163"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.1995.tb01988.x"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.physiol.62.1.825"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199805000-00021"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.39.4.536"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200207-690OC"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950110213"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950060402"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60101-4"},{"key":"R24","unstructured":"Marshall BE\n                      and Marshall C.\n                      Pulmonary hypertension. 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