ABSTRACT. I n vivo substrate utilization has not been described for the maturing fetal lung. We, therefore, studied pulmonary delivery and use of major fetal substrates in six chronically catheterized fetal lambs over 119-141 days gestation. Oxygen, glucose, lactate, and a-amino nitrogen concentrations were measured in the pulmonary artery and pulmonary vein whereas lung blood flow was determined using labeled microspheres. We found that lung oxygen availability and use increased near term.
606Using the chronically catheterized fetal sheep model (6), we determined the availability of major fetal substrates to the developing lung and lung substrate utilization during the third trimester. Pulmonary delivery and uptake of oxygen, glucose, lactate, and a-amino nitrogen were followed over the last weeks of gestation, allowing us to define the changing pattern of pulmonary substrate availability and use that accompanies advancing gestation.
METHODSSurgical preparation and recovery. Six mixed Western, breeddated, pregnant sheep of 1 15-125 days gestation were surgically prepared with indwelling catheters, using methods described previously (6). Six fetal lambs were catheterized, five singletons and one from a set of twins. Surgery was performed after the animals had fasted 24 h. Spinal anesthesia was induced with 2.0 ml of 1 % tetracaine hydrochloride and analgesia was provided with intravenous pentobarbital (65 mg/ml) as needed. Polyvinyl catheters (0.050 inch inner diameter and 0.090 inch outer diameter) were placed in the maternal femoral artery and vein. The uterus was then exposed through a midline abdominal incision and opened. Local anesthesia with 1% xylocaine was used for all fetal incisions; pentobarbital (5-10 mg/kg) and succinyl choline (1 mg/kg) were given as needed for fetal sedation and to minimize fetal movement. Catheters (0.030 inch inner diameter and 0.048 inch outer diameter) were inserted either into the fetal femoral artery and vein of one hindlimb (four animals) or into the carotid artery and jugular vein (two animals). The fetal chest was then exposed and a thoracic incision was made on the left side, from sternum to spine. The pleural space was entered through the fourth intercostal space and the lungs were gently retracted. The pericardium was opened and a 20-gauge Teflon catheter, fitted on a piece of polyvinyl tubing (7), was then placed into the main pulmonary artery. A catheter (0.01 1 inch inner diameter and 0.030 inch outer diameter) was inserted into a distal pulmonary vein and threaded up into a major vein draining the upper lobe of the left fetal lung. The fetal chest was then closed. A multipore amniotic fluid catheter was anchored in the uterus and the uterus was also sutured closed. All catheters were exteriorized through a stab wound in the maternal flank, where they were protected by a mesh pocket. At surgery, penicillin (1 million units) and kanamycin (200 mg) were given to the ewe intravenously and were also instilled into the amniotic cavity.After surgery the ewes were fed ad...