{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T17:14:28Z","timestamp":1763226868339,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HD096299","HD072929"],"award-info":[{"award-number":["HD096299","HD072929"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The aim was to evaluate the relationship between the direction of the patent ductus arteriosus (PDA) shunt and the pre- and postductal gradient for arterial blood gas (ABG) parameters in a lamb model of meconium aspiration syndrome (MAS) with persistent pulmonary hypertension of the newborn (PPHN). Methods: PPHN was induced by intermittent umbilical cord occlusion and the aspiration of meconium through the tracheal tube. After delivery, 13 lambs were ventilated and simultaneous 129 pairs of pre- and postductal ABG were drawn (right carotid and umbilical artery, respectively) while recording the PDA and the carotid and pulmonary blood flow. Results: Meconium aspiration resulted in hypoxemia. The bidirectional ductal shunt had a lower postductal partial arterial oxygen tension ([PaO2] with lower PaO2\/FiO2 ratio\u201497 \u00b1 36 vs. 130 \u00b1 65 mmHg) and left pulmonary flow (81 \u00b1 52 vs. 133 \u00b1 82 mL\/kg\/min). However, 56% of the samples with a bidirectional shunt had a pre- and postductal saturation gradient of &lt; 3%. Conclusions: The presence of a bidirectional ductal shunt is associated with hypoxemia and low pulmonary blood flow. The absence of a pre- and postductal saturation difference is frequently observed with bidirectional right-to-left shunting through the PDA, and does not exclude a diagnosis of PPHN in this model.<\/jats:p>","DOI":"10.3390\/children7090137","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T10:24:09Z","timestamp":1600165449000},"page":"137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bidirectional Ductal Shunting and Preductal to Postductal Oxygenation Gradient in Persistent Pulmonary Hypertension of the Newborn"],"prefix":"10.3390","volume":"7","author":[{"given":"Amy","family":"Lesneski","sequence":"first","affiliation":[{"name":"Davis School of Medicine, University of California, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"Hardie","sequence":"additional","affiliation":[{"name":"Davis School of Medicine, University of California, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Ferrier","sequence":"additional","affiliation":[{"name":"Davis School of Medicine, University of California, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6098-2155","authenticated-orcid":false,"given":"Satyan","family":"Lakshminrusimha","sequence":"additional","affiliation":[{"name":"Davis School of Medicine, University of California, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Payam","family":"Vali","sequence":"additional","affiliation":[{"name":"Davis School of Medicine, University of California, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e680","DOI":"10.1542\/neo.16-12-e680","article-title":"Persistent pulmonary hypertension of the newborn","volume":"16","author":"Lakshminrusimha","year":"2015","journal-title":"Neoreviews"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1053\/j.semperi.2013.11.004","article-title":"Update on PPHN: Mechanisms and treatment","volume":"38","author":"Nair","year":"2014","journal-title":"Semin. Perinatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e1259","DOI":"10.1542\/peds.2011-1317","article-title":"Strategies for implementing screening for critical congenital heart disease","volume":"128","author":"Kemper","year":"2011","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/S0140-6736(11)61032-5","article-title":"Screening with pulse oximetry for congenital heart disease","volume":"378","author":"Mahle","year":"2011","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1111\/apa.13742","article-title":"The limitations of pulse oximetry for critical congenital heart disease screening in the neonatal intensive care units","volume":"106","author":"Fernandes","year":"2017","journal-title":"Acta Paediatr."},{"key":"ref_6","first-page":"67","article-title":"Critical congenital heart disease screening by pulse oximetry in a neonatal intensive care unit","volume":"35","author":"Manja","year":"2015","journal-title":"J. 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Care Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/7\/9\/137\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:10:17Z","timestamp":1760177417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/7\/9\/137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,15]]},"references-count":13,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["children7090137"],"URL":"https:\/\/doi.org\/10.3390\/children7090137","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2020,9,15]]}}}