Preliminary report on partial pressure changes of oxygen and carbon dioxide in umbilical artery and vein before and after the first breath in Chinese neonates I—The group difference of partial pressure of oxygen and carbon dioxide between umbilical artery and vein in newborns

doi:10.12047/j.cjap.0099.2021.098

Abstract

Abstract: Objective: The fetus has no actual respiration, and the newborn begins to breathe after birth. We assume that the first breath dominantly generated by hypoxia. In this study, the changes and lowest limit of blood oxygen partial pressureof umbilical artery (PuaO₂) after chemoreceptor were analyzed to explore the mechanism of neonatal spontaneous breathing. Methods: With signed consent form by all fetal parents before birth, 14 newborns successfully completed the umbilical artery or vein catheterization and drawn blood according to the heartbeat. All blood samples analyzed by blood gas analyzer,calculated and analyzed the similarities and differences between umbilical vein(Puv) and umbilical artery(Pua). Results: Although we completed 14 newborns, there were only 9 cases of umbilical artery samples and 8 cases of umbilical vein samples were collected. Only 3 cases collected both Pua and Puv blood samples at the same time (see serial paper II). PuaO₂ in gradually decreased with time (heartbeat frequency), until Pua contracted after spontaneous breathing produced about 8~10 heartbeats, and then could not get enough blood samples. Only 3 newborns were able to take blood samples after spontaneous breathing for 8~10 heartbeats, and their PuaO₂ were jumped to 186.0, 137.0 and 93.8 mmHg respectively. The mean value of PuaO₂ was (25.94±6.79, 18.04~37.51)mmHg, the highest value was (29.11±6.46, 23.00~45.90)mmHg, and the lowest value was (21.34±5.54, 14.00~33.60)mmHg. Although PuvO₂ decreased gradually with time (heartbeat) too, most of them also showed the tendency of alternately rising and falling with the regularity of mother's respiration. The mean value of PuvO₂ was (53.35±21.35, 32.56~100.73)mmHg, the highest value was (90.38±48.44, 43.40~153.00)mmHg, and the lowest value was (36.96±14.90, 24.80~73.80)mmHg. Although there were large individual differences, the mean, highest and lowest values of PuvO₂ were significantly higher than those of PuaO₂ (P<0.05); although PuvCO₂ slightly lower than PuaCO₂, it was no significant difference (P>0.05). Conclusion: PuaO₂decreases gradually with time before spontaneous breathing after the delivered fetus as a newborn, and it induces the first inhalation to start spontaneous breathing when it reaches the threshold of triggering breathing.

Key words: newborn after birth before breathing, umbilical artery and umbilical vein take blood continuously, blood gas analysis, umbilical arterial oxygen partial pressure, respiratory regulation control signal

CLC Number:

R332

LIU Fang, SUN Xing-guo, LI Qi-wei, GE Wan-gang, LI Hao, LIU Yan-ling, CI Zheng, CHEN Sheng-ping, SONG Gui-qin, WANG Gui-zhi, TAN Xiao-yue, CUI Yan, ZHANG Ye, ZHU Jia-bao, LI Yin-jun, DENG Wei, HUANG Yan, MA Ming-xin, CHEN Rong, ZOU Yu-xin, TAI Wen-qi, XU Fan, SHI Chao. Preliminary report on partial pressure changes of oxygen and carbon dioxide in umbilical artery and vein before and after the first breath in Chinese neonates I—The group difference of partial pressure of oxygen and carbon dioxide between umbilical artery and vein in newborns[J]. CJAP, 2021, 37(1): 1-8.

References

[1] Sun XG, Guo ZY. New theory of breathing control: a complex model integrates multi-systems [J]. FASEB J, 2011, 25: A LB634.
[2] Sun XG, Guo ZY. Decreased magnitudes of arterial O₂ and CO₂ oscillation explain Cheyne-Stokes periodic breathing pattern in heart failure patients [J]. FASEB J, 2011, 25: A847.24.
[3] Sun XG, Hansen JE, Beshai JF, et al. Oscillatory breathing and exercise gas exchange abnormalities prognosticate early mortality and Morbidity in Heart Failure[J]. J Am Coll Cardiol, 2010, 55(17): 1814-1823.
[4] Sun XG.A dynamic model integrates multi-systems for breathing control[C]. ACCP/Chest-2011, Honolulu, USA, October 22-26, 2011.
[5] Sun XG.A new theory (dynamic model) of circulatory control[J]. J Ningxia Med Univ, 2011, 33(Suppl): 21.
[6] Sun XG, Stringer WW.Circulatory effects on breath: Left ventricle function affects on damping of breathing control signals[C]. ACCP/Chest-2011, Honolulu, USA, October 22-26, 2011.
[7] Sun XG.Breathing control mechanism I: The trigger of next breath[J]. Respirology, 2011, 16(Suppl2): 289.
[8] Sun XG.Breathing control mechanism II: The original generator of breath rhythm[J]. Respirology, 2011, 16(Suppl2): 289-290.
[9] Sun XG.Breathing control mechanism III: The integrative mechanism of CNS on breathing control (and circulation control)[J]. Respirology, 2011, 16(Suppl2): 241.
[10] Sun XG.Breathing control mechanism IV: New mechanism of obstructive sleep apnea[J]. Respirology, 2011, 16(Suppl2): 242-243.
[11] Sun XG.Breathing control mechanism V: Why Sleep Apnea appears in patient with cardiovascular Diseases?[J]. Respirology, 2011, 16(Suppl2): 243.
[12] Sun XG.Cardiopulmonary exercise testing is the most important method of diagnosis, evaluation, treatment (rehabilitation) and prognosis for pulmonary vascular diseases[J]. Respirology, 2011, 16(Suppl2): 301.
[13] Sun XG. Cardiopulmonary coupling I: Ejection fraction effects on initiator signals of next breathing[J]. FASEB J, 2012, 26: A 1148.12.
[14] Sun XG. Cardiopulmonary coupling II: Reduced stroke volume effects on time phase of signals'combination at integrative site in CNS[J]. FASEB J, 2012, 26: A 1148.13.
[15] Sun XG. The integrative model of nervous system for new theory of control and regulation of breathing[J]. FASEB J, 2012, 26: A LB798.
[16] Hansen JE, Sun XG, Stringer WW.A simple new visualization of exercise data discloses pathophysiology and severity of heart failure[J]. J Am Heart Assoc, 2012, 1(3): e001883.
[17] Sun XG.Integrated circulation and respiration in physiology and medicine I: Why we changed our circulatory structure and function after birth[C]. //APS Conference (Autonomic regulation of cardiovascular function and diseases), Omaha, Nebraska, USA, July 7-10, 2012.
[18] Sun XG.Integrated circulation and respiration in physiology and medicine II: Why variations of HR, SBP and anatomic tone follow respiratory rhythm[C]. //APS Conference (Autonomic regulation of cardiovascular function and diseases), Omaha, Nebraska, USA, July 7-10, 2012.
[19] Sun XG.Integrated circulation and respiration in physiology and medicine III: Why HF patients appear oscillatory breathing during sleep and exercise[C]. //APS Conference (Autonomic regulation of cardiovascular function and diseases), Omaha, Nebraska, USA, July 7-10, 2012.
[20] Sun XG.Integrated circulation and respiration in physiology and medicine IV: Why and how body blood flow redistribution during exercise?[C]. //APS Conference (Autonomic regulation of cardiovascular function and diseases), Omaha, Nebraska, USA, July 7-10, 2012.
[21] Sun XG.Integrated circulation and respiration in physiology and medicine V: Why and how to increase the cardiac output (CO) during exercise?[C]. //APS Conference (Autonomic regulation of cardiovascular function and diseases), Omaha, Nebraska, USA, July 7-10, 2012.
[22] Sun XG.Holistic life control and regulation: The theoretical system of holistic physiology[J]. Acta Physiologica Sinca, 2012, 64(Suppl I): 126.
[23] Sun XG, Hansen JE, Stringer WW.Oxygen uptake efciency plateau (OUEP) best predicts early death in heart failure[J]. Chest, 2012, 141(5): 1284-1294.
[24] 孙兴国. 整体整合生理学医学新理论体系: 人体功能一体化自主调控[J]. 中国循环杂志, 2013, 28(2): 88-92.
[25] 孙兴国. 生命整体调控新理论体系与心肺运动试验[J]. 医学与哲学(人文社会医学版), 2013, 34(3): 22-27.
[26] 孙兴国. 整体整合生理学医学新理论体系概论I:呼吸调控新视野[J].中国应用生理学杂志, 2015, 31(4): 295-301.
[27] 孙兴国. 整体整合生理学医学新理论体系概论II:循环调控新视野[J].中国应用生理学杂志, 2015, 31(4): 302-307.
[28] 孙兴国. 整体整合生理学医学新理论体系概论III:呼吸循环代谢一体化调控环路中神经体液作用模式[J]. 中国应用生理学杂志, 2015, 31(4): 308-315.
[29] 孙兴国,姚优修,李军,等. 人体动脉血气信号波浪式变化及连续动脉逐搏取血血气分析方法的建立[J]. 中国应用生理学杂志, 2015, 31(4): 316-321.
[30] 姚优修,孙兴国,李军,等. 心衰患者动脉血气波浪式变化及其幅度降低的初步实验证据[J]. 中国应用生理学杂志, 2015, 31(4): 322-325.
[31] Sun XG, Hansen JE, Stringer WW, et al. Carbon dioxide pressure-concentration relationship in arterial and mixed venous blood during exercise[J]. J Appl Physiol, 2001, 90(5): 1798-1810.
[32] Sun XG, Hansen JE, Wasserman K, et al. Comparison of exercise cardiac output by the fick principle using oxygen and carbon dioxide[J]. Chest, 2000, 118(3): 631-640.
[33] 尹希,孙兴国,Stringer WW,等. 代谢、血液碱化和纯氧影响呼吸调控的人体实验研究I:运动试验[J]. 中国应用生理学杂志, 2015, 31(4): 341-344.
[34] 孙兴国, Stringer WW,尹希,等. 代谢、血液碱化和纯氧影响呼吸调控的人体实验研究II:血液碱化后运动试验[J]. 中国应用生理学杂志, 2015, 31(4): 345-348.
[35] 孙兴国, Stringer WW,尹希,等. 代谢、血液碱化和纯氧影响呼吸调控的人体实验研究III:血液碱化后纯氧运动试验[J]. 中国应用生理学杂志, 2015, 31(4): 349-352.
[36] 崔闫,孙兴国,葛万刚,等.人体动脉血气波浪式变化特点的实验证据-同时间动、静脉血波浪式变化幅度的不同[J]. 中国应用生理学杂志, 2021, 37(1): 34-39.
[37] 刘方,孙兴国,李启威,等. 新生儿首次呼吸前后脐带动静脉血液氧和二氧化碳变化探索呼吸调控机制的初步报告II—同一个新生儿同一时间的脐带动静脉血液氧和二氧化碳分压差值组间分析[J]. 中国应用生理学杂志, 2021, 37(1): 9-14.
[38] 崔闫,孙兴国,葛万刚,等.人体通气状态对动脉血气波浪式幅度的影响[J]. 中国应用生理学杂志, 2021, 37(1): 40-44.
[39] 王桂芝,孙兴国, 陈荣声,等. 活体动物机械通气下不同潮气量影响动脉血氧变化幅度的实验研究初步报告[J]. 中国应用生理学杂志, 2021, 37(1): 45-50.
[40] 孙兴国,陈荣声,王桂芝,等. 活体动物机械通气下不同潮气量影响动脉血氧变化幅度的实验研究初步报告[J]. 中国应用生理学杂志, 2021, 37(1): 104-112.
[41] Chen R, Formenti F, McPeak H, et al. Optimizing design for polymer fiber optic oxygen sensors[J]. IEEE Sens J, 2014, 14: 3358-3364.
[42] 孙兴国,黄雪琦,王德君,等.国人新生儿呼吸道应用解剖的观察和测量[J].中华麻醉学杂志, 1988, 8(4): 202-203.