{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:58:28Z","timestamp":1760234308532,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R03 HD086531-01"],"award-info":[{"award-number":["R03 HD086531-01"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation\u2013SI vs. positive pressure ventilation\u2013V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated near-term lambs. We hypothesized that SI with DCC improves gas exchange and hemodynamics in near-term lambs with asphyxial bradycardia. A total of 28 lambs were asphyxiated to a mean blood pressure of 22 mmHg. Lambs were randomized based on the timing of cord clamping (ECC\u2014immediate, DCC\u201460 s) and mode of initial ventilation into five groups: ECC + V, ECC + SI, DCC, DCC + V and DCC + SI. The magnitude of placental transfusion was assessed using biotinylated RBC. Though an asphyxial bradycardia model, 2\u20133 lambs in each group were arrested. There was no difference in primary outcomes, the time to reach baseline carotid blood flow (CBF), HR \u2265 100 bpm or MBP \u2265 40 mmHg. SI reduced pulmonary (PBF) and umbilical venous (UV) blood flow without affecting CBF or umbilical arterial blood flow. A significant reduction in PBF with SI persisted for a few minutes after birth. In our model of perinatal asphyxia, an initial SI breath increased airway pressure, and reduced PBF and UV return with an intact cord. Further clinical studies evaluating the timing of cord clamping and ventilation strategy in asphyxiated infants are warranted.<\/jats:p>","DOI":"10.3390\/children8050353","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T01:43:24Z","timestamp":1619660604000},"page":"353","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3846-2027","authenticated-orcid":false,"given":"Jayasree","family":"Nair","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"},{"name":"Buffalo Neonatology Associates, Sisters of Charity Hospital, Buffalo, NY 14214, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Gugino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmon","family":"Koenigsknecht","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Helman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6704-6949","authenticated-orcid":false,"given":"Deepika","family":"Sankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California at Davis, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-7197","authenticated-orcid":false,"given":"Vikash","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"},{"name":"Department of Pediatrics, Loma Linda University, Loma Linda, CA 92350, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-3017","authenticated-orcid":false,"given":"Praveen","family":"Chandrasekharan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munmun","family":"Rawat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara K.","family":"Berkelhamer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"},{"name":"Department of Pediatrics, University of Washington, Seattle, WA 98195, 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":"Department of Pediatrics, University of California at Davis, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"Nair, J., and Kumar, V.H.S. 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