Abstract
In the fetus, the pulmonary circulation is actively maintained in a constricted state due to low oxygen environment and perhaps leukotrienes. Pulmonary blood flow represents about 8% of fetal cardiac output. Shortly after birth, pulmonary vascular resistance (PVR) and pulmonary arterial pressure fall rapidly, whereas pulmonary blood flow reaches systemic levels. The exact mechanisms by which the dramatic changes in PVR occur with the onset of ventilation at birth are extensively reviewed. They include: oxygen environment and release of vasoactive substances such as bradykinin, PGI2 or PGD2. Thus, regulation of the fetal and immediate postnatal pulmonary circulation reflects a balance between factors producing active pulmonary vasoconstriction and those producing vasodilatation.
Similar content being viewed by others
References
Rudolph AM, Heymann MA (1970) Circulatory changes during growth in the fetal lamb. Circ Res 26:289
Heymann MA, Creasy RK, Rudolph AM (1973) Quantitation of blood flow patterns in the foetal lamb in utero. In: Comline KS, Cross KW, Dawes GS, Nathanielsz PW (eds) Foetal and neonatal-physiology. Proceedings of the Sir Joseph Barcroft Centenary Symposium, Cambridge University Press, Cambridge, pp 129–135
Kuipers JRG, Sidi D, Heymann MA, Rudolph AM (1982) Comparison of methods of measuring cardiac output in newborn lambs. Pediatr Res 16:594
Moss AJ, Emmanouilides G, Duffie ER Jr (1963) Closure of the ductus arteriosus in the newborn infant. Pediatrics 32:25
Lucas RV Jr, St Geme JW Jr, Anderson RC, Adams P Jr, Ferguson DJ (1961) Maturation of the pulmonary vascular bed: a physiologic and anatomic correlation in infants and children. Am J Dis Child 101: 467
Lewis AB, Heymann MA, Rudolph AM (1976) Gestational changes in pulmonary vascular responses in fetal lambs in utero. Circ Res 39:536
Heymann MA, Rudolph AM, Nies AS, Melmon KL (1969) Bradykinin production associated with oxygenation of the fetal lamb. Circ Res 25:521
Rudolph AM, Yuan S (1966) Response of the pulmonary vasculature to hypoxia and H+ concentration changes. J Clin Invest 45:399
Cassin S, Dawes GS, Ross BB (1964) Pulmonary blood flow and vascular resistance in immature foetal lambs. J Physiol (Lond) 171:80
Campbell AGM, Dawes GS, Fishman AP, Hyman AI (1967) Pulmonary vasoconstriction and changes in heart rate during asphyxia in immature foetal lambs. J Physiol (Lond) 192:93
McIntyre TM, Zimmerman GA, Satoh K, Prescott SM (1985) Cultured endothelial cells synthesize both platelet-activating factor and prostacyclin in response to histamine, bradykinin, and adenosine triphosphate. J Clin Invest 76:271
Cassin S, Dawes GS, Mott JC, Ross BB, Strang LB (1964) The vascular resistance of the foetal and newly ventilated lung of the lamb. J Physiol (Lond) 171:61
Cassin S (1980) Role of prostaglandins and thromboxanes in the control of the pulmonary circulation in the fetus and newborn. Semin Perinatol 4:101
Gryglewski RJ (1980) The lung as a generator of prostacyclin. Ciba Found Symp 78:147
Leffler CW, Hessler JR, Green RS (1984) Mechanism of stimulation of pulmonary prostaglandin synthesis at birth. Prostaglandins 28:877
Omini C, Vigano T, Marini A, Pasargiklian R, Fano M, Maselli MA (1983) Angiotensin II: a releaser of PGI2 from fetal and newborn rabbit lungs. Prostaglandins 25:901
VanGrondelle A, Worthen S, Ellis D, Mathias MM, Murphy RC, Murphy RJ, Strife J, Reeves JT, Voelkel NF (1984) Altering hydrodynamic variables influences PGI2 production by isolated lungs and endothelial cells. J Appl Physiol 57:388
Soifer SJ, Morin FC III, Kaslow DC, Heymann MA (1983) The developmental effects of PGD2 on the pulmonary and systemic circulations in the newborn lamb. J Dev Physiol 5:237
Schwartz LW, Osburn BI, Frick OL (1974) An ontogenic study of histamine and mast cells in the fetal rhesus monkey. J Allergy Clin Immunol 56:381
Leffler CW, Tyler TL, Cassin S (1978) Effects of indomethacin on pulmonary vascular response to ventilation of fetal goats. Am J Physiol 234:H346
Voelkel NF, Chang SW, Pfeffer KD, Worthen SG, McMurtry IF, Henson PM (1986) PAF antagonists: different effects on platelets, neutrophils, guinea pig ileum and PAF-induced vasodilation in isolated rat lung. Prostaglandins 32:359
Soifer SJ, Loitz RD, Roman C, Heymann MA (1985) Leukotriene end organ antagonists increase pulmonary blood flow in fetal lambs. Am J Physiol 249:H570
Voelkel NF (1986) Mechanisms of hypoxic pulmonary vasoconstriction. Am Rev Respir Dis 133:1186
Rojas J, Larsson LE, Ogletree ML, Brigham KL, Stahlman MT (1983) Effects of cyclooxygenase inhibition on the response to group B streptococcal toxin in sheep. Pediatr Res 17:107
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Heymann, M.A. Regulation of the pulmonary circulation in the perinatal period and in children. Intensive Care Med 15 (Suppl 1), S9–S12 (1989). https://doi.org/10.1007/BF00260875
Issue Date:
DOI: https://doi.org/10.1007/BF00260875