Objective To compare fractional moving blood volume (FMBV) ResultsIn the asphyxia group, all lambs showed a marked reduction in the adrenal blood perfusion towards the third RMS injection. In the control group, the adrenal perfusion showed small variations throughout the experiment. In the total material, there was a higher correlation between FMBV and RMS (median, r = 0.90; range, r = 0.55; range,. ConclusionThe FMBV method of quantifying PDU signals correlates highly with blood flow perfusion estimation using RMS in the fetal lamb adrenal gland.

Aim: Early human milk feeding is beneficial for gut and brain development. Persistent ductus arteriosus (PDA) and indomethacin may compromise enteral function in preterm infants. For many years enteral milk feedings have continued in preterm infants receiving indomethacin for PDA. The aim of this study was to investigate whether this strategy is efficient in terms of risks and tolerance to early enteral feeding. Methods: This retrospective study included 64 inborn infants of <29 wk gestational age (GA), 32 infants who received indomethacin for symptomatic PDA (case infants) and 32 matched controls. Case infants had a mean (SD) GA of 26.3 wk (1.3) and body weight 839 g (203) versus controls GA 26.4 wk (1.2) and body weight 896 g (213) (p= 0.82 and 0.27, respectively). Case infants had higher respiratory morbidity; 90.6% versus 50% of controls needed mechanical ventilation (p= 0.000). Results: Case infants received human milk from a median (range) age of 4.0 h (1.5‐27.5), and controls from 5.3 h (2.0‐38.0) (p= 0.092). The first dose of indomethacin was given at a mean age of 1.7 d (1.0). There were no differences between the two groups in feeding volumes or gastric residuals on days 1 to 7. Mean (SD) feeding volume on day 7 was 64 ml/kg (31) in case infants and 76 ml/kg (30) in controls (p= 0.23). Four infants developed necrotizing enterocolitis: two case infants and two controls (p= 1.00). Conclusion: Early enteral feeding with human milk, starting within the first hours of life, seems to be as well tolerated in preterm infants treated with indomethacin for PDA as in their matched controls.

Type and duration of fetal asphyxial insult affect the distribution of blood flow to the heart and brain. The purpose of this study was to describe dynamic and quantitative changes in regional myocardial and cerebral blood flow (CBF) during fetal asphyxia induced by total occlusion of the umbilical cord. Eleven exteriorized fetal sheep were subjected to total umbilical cord occlusion and five fetal sheep served as sham controls. Regional blood flow (BF) to the brain and heart was quantified using radioactive microspheres before and after 5 min of occlusion and finally when fetal mean arterial blood pressure had decreased below 25 mm Hg, 9.8 (0.8) [mean (SD)] min after occlusion. Right coronary arterial (RCA) blood flow velocity and carotid BF were registered continuously. Mean values of arterial pH and oxygen content (mL O 2 /100 mL) were 7.08 (0.11) and 4.4 (2.9) before cord occlusion and decreased to 6.83 (0.05) and 1.4 (0.9) at 5 min after occlusion (p Ͻ 0.01, respectively). Carotid BF was significantly below preocclusion values by 2.5 min (p Ͻ 0.05), whereas RCA velocity time integral per minute remained above preocclusion values for 9 min. CBF decreased from 316 (24) before cord occlusion to 156 (30) mL/min/100 g at 5 min (p Ͻ 0.01), whereas right myocardial BF was maintained at 792 (125) and 751 (183) mL/min/100 g, respectively. CBF decreased rapidly after total cord occlusion whereas myocardial BF increased and was maintained until shortly before cardiac arrest, suggesting the myocardium to be better preserved during this type of insult in already partially asphyxiated fetuses. The vascular response of the heart and brain to acute asphyxia in the late gestation fetus varies according to type and rapidity of insult. As opposed to the centralization of flow in fetal hypoxemia with a well-established compensatory increase to the brain and heart, acute asphyxia may result in a variety of vascular responses. Total cord occlusion has resulted in an early decrease in carotid blood flow, suggesting a vulnerability of the fetal brain during an early stage of the insult (1). The decrease in carotid blood flow and cerebral blood volume was accompanied by an increase in carotid vascular resistance.Localization of regional brain damage has been attributed to differences in timing of the asphyxial insult (2, 3). The regional vascular response within the brain during the asphyxial insult has been sparsely investigated. Thus, differences in vascular reactivity within the brain due to variations in type and timing of the insult may predispose to selective regional vulnerability of brain structures.A previous study reporting an early decrease in carotid blood flow during acute asphyxia with maintained blood pressure suggested that this decrease was not due to cardiac compromise (1). We postulated that myocardial and cerebral perfusion are differentially regulated during acute asphyxia. Studies of early concomitant changes in CBF and myocardial BF in response to sustained periods of total cord occlusion have not been per-