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The effect of inhaled nitric oxide on intestinal perfusion in the neonatal piglet

Grant number: 22/12021-1
Support Opportunities:Scholarships abroad - Research
Start date: February 13, 2023
End date: February 10, 2024
Field of knowledge:Health Sciences - Medicine - Surgery
Principal Investigator:Lourenço Sbragia Neto
Grantee:Lourenço Sbragia Neto
Host Investigator: Oluyinka O. Olutoye
Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
Institution abroad: Nationwide Children's Hospital, United States  

Abstract

Necrotizing enterocolitis (NEC) affects 3 children per 1,000 live births. It is the most common gastrointestinal emergency in newborns. It involves an initial injury to the intestinal tract that we believe is related to poor blood flow. As the disease progresses, the intestines may die and may require surgical removal. Recent studies have suggested that the severity of NEC can be lessened through remote ischemic conditioning (RIC). RIC therapy performed on mice with NEC demonstrated that the temporary blockage of blood vessels in an area of the body makes distant tissues resistant to damage caused by the poor blood flow seen in NEC. The treatment has been shown to increase intestinal blood circulation after repeated treatment and decrease intestinal damage. Such beneficial effects of RIC were shown to be dependent on the dilation of blood vessels mediated by nitric oxide (NO), which is an important molecule in lung physiology for mediating blood vessel dilation and oxygenation in the pulmonary and intestinal circulation. Inhaled nitric oxide (iNO) is given to some neonates with certain respiratory disorders. Part of the iNO is absorbed into the bloodstream. This study aims to assess whether the amount of iNO absorbed into the circulation is sufficient to impact intestinal perfusion and oxygen content measured by abdominal near-infrared spectroscopy (NIRS). NIRS allows us to measure the levels of oxygen in the blood going to the intestines. We hypothesise that there is a direct relationship between iNO concentration and intestinal blood flow that can be measured by abdominal NIRS. The Nationwide Children's Hospital laboratory has many years of experience with the piglet model. To model newborn intestinal prematurity, the swine NEC model, although more expensive, is superior to other animal models with its similarity in intestinal anatomical structure and body size equivalent to a premature human baby. (AU)

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Scientific publications (11)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CANESIN, W. C.; VOLPE, F. P.; FALQUETTI, L.; MARQUES, M. Q.; MARQUES, I. C. S.; SAIA, R. S.; GADDE, R.; GARCIA, S. B.; SBRAGIA, L.. Botulinum toxin improved intestinal adaptation to short gut in a twenty-one-day-old weanling rat. Brazilian Journal of Medical and Biological Research, v. 58, p. 8-pg., . (22/12021-1)
ANA MARIA BICUDO DINIZ; IGOR JOSÉ NOGUEIRA GUALBERTO; LUIZA ALMEIDA LIMA; MUCIO LUIZ DE ASSIS CIRINO; RODRIGO KENDI MURAKAMI; BELLA LUNA COLOMBINI ISHIKIRIAMA; RODRIGO RUANO; LUIZ FERNANDO FERRAZ DA SILVA; DANIELA TIRAPELLI; LOURENÇO SBRAGIA. miRNA-143 expression is associated with inflammation and time of exposure to amniotic fluid in experimental gastroschisis. Clinics, v. 78, . (22/12021-1)
NOUR, A. L. A.; FABRO, A. T.; BATAH, S. S.; ORIA, M.; PEIRO, J. L.; SBRAGIA, L.. The myocardial capillary network is altered in congenital diaphragmatic hernia in the fetal rabbit model. Brazilian Journal of Medical and Biological Research, v. 56, p. 8-pg., . (21/09024-6, 22/12021-1)
YOUNG, KAREN C.; SCHMIDT, AUGUSTO F.; TAN, APRIL W.; SBRAGIA, LOURENCO; ELSAIE, AHMED; SHIVANNA, BINOY. Pathogenesis and Physiologic Mechanisms of Neonatal Pulmonary Hypertension: Preclinical Studies. CLINICS IN PERINATOLOGY, v. 51, n. 1, p. 23-pg., . (22/12021-1)
CANESIN, WELLEN CRISTINA; VOLPE, FABIO PERECIN; FERRI, WALUSA ASSAD GONCALVES; GADDE, RAHUL; ORTOLAN, ERIKA VERUSKA PAIVA; TEDESCO, BRUNA ALIOTTO NALIN; LOURENCAO, PEDRO LUIZ TOLEDO DE ARRUDA; SBRAGIA, LOURENCO. Analysis of risk factors for neonatal short bowel syndrome in two tertiary centers in Brazil. JOURNAL OF PEDIATRIC SURGERY OPEN, v. 4, p. 7-pg., . (22/12021-1)
RAPHAEL DEL ROIO LIBERATORE JUNIOR; ISABELLA CHRISTINA MAZZARO MONTEIRO; FLAVIO DE OLIVEIRA PILEGGI; WELLEN CRISTINA CANESIN; LOURENÇO SBRAGIA. Congenital hyperinsulinism and surgical outcome in a single tertiary center in Brazil. Jornal de Pediatria, v. 100, n. 2, p. 163-168, . (22/12021-1)
SBRAGIA, LOURENCO; GUALBERTO, IGOR JOSE NOGUEIRA; XIA, JASON; GADDE, RAHUL; SAULSBERY, ANGELA; HAMEEDI, SOPHIA; DALTO, ANA LAURA FERREIRA MARSICO; OLUTOYE, OLUYINKA O.. Intestinal Fatty Acid- Binding Protein as a Marker of Necrotizing Enterocolitis Incidence and Severity: A Scoping Review. JOURNAL OF SURGICAL RESEARCH, v. 303, p. 15-pg., . (22/12021-1)
BRESSAN, ALECSANDER F.; FIGUEIRA, REBECA LOPES; DA COSTA, KARINA MIURA; NOUR, ANTONIO LANDOLFFI ABDUL; FERREIRA, GRAZIELA CRISTINA; ALAVARSE, MATHEUS V.; GADDE, RAHUL; FABRO, ALEXANDRE TODOROVIC; TANUS-SANTOS, JOSE EDUARDO; SBRAGIA, LOURENCO. Prenatal treatment with nitrite reduces pulmonary arteriolar remodeling in neonates with congenital diaphragmatic hernia. ADVANCES IN REDOX RESEARCH, v. 11, p. 6-pg., . (22/12021-1)
MEDEIROS, GABRIEL ARAUJO; GUALBERTO, IGOR JOSE NOGUEIRA; DA SILVA, CARLOS HENRIQUE NASCIMENTO DOMINGUES; DINIZ, ANA MARIA BICUDO; DE SANTANA, JAN BEATRIZ FELINTO; VOLPE, FABIO PERECIN; GADDE, RAHUL; MAZZO, ALESSANDRA; DE OLIVEIRA, RODRIGO CARDOSO; SBRAGIA, LOURENCO. Development of a low-cost congenital abdominal wall defect simulator (wall-go) for undergraduate medical education: a validation study. BMC MEDICAL EDUCATION, v. 23, n. 1, p. 10-pg., . (22/12021-1)
GADDE, RAHUL; XIA, JASON; HAMEEDI, SOPHIA; SAULSBERY, ANGELA; SCHAFER, CARLY; SBRAGIA, LOURENCO; OLUTOYE, OLUYINKA O.. Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC)- Validation in a Large Animal Model. JOURNAL OF PEDIATRIC SURGERY, v. 60, n. 1, p. 5-pg., . (22/12021-1)
MASSUDA, EDUARDO TANAKA; SEIBERT, SOLANGE NATALIA; DINIZ, ANA MARIA BICUDO; LIMA, LUIZA ALMEIDA; ROSSATO, MARIA; DA FONSECA, VANESSA MACIEL BRAULIO; BORGES, MARCOS DE CARVALHO; XIA, JASON; FABBRO, AMAURY LELIS DAL; SBRAGIA, LOURENCO. Ventilation with hyperoxia promotes cochlear bleeding in rabbits with congenital diaphragmatic hernia. Clinics, v. 79, p. 6-pg., . (22/12021-1)