Terrence L Hubert

Temple University, Philadelphia, Pennsylvania, United States

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Publications (6)7.33 Total impact

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    ABSTRACT: It is common practice during one lung ventilation (OLV) to use 100% oxygen, although this may cause hyperoxia- and oxidative stress-related lung injury. We hypothesized that lower oxygen (FiO(2) ) during OLV will result in less inflammatory and oxidative lung injury and improved lung function. Twenty pigs (8.88 ± 0.84 kg; 38 ± 4.6 days) were assigned to either the hyperoxia group (n = 10; FiO(2)  = 100%) or the normoxia group (n = 10; FiO(2)  < 50%). Both groups were subjected to 3 hr of OLV. Blood samples were tested for pro-inflammatory cytokines and lung tissue was tested for these cytokines and oxidative biomarkers. There were no differences between groups for partial pressure of CO(2) , tidal volume, end-tidal CO(2) , plasma cytokines, or respiratory compliance. Total respiratory resistance was greater in the hyperoxia group (P = 0.02). There were higher levels of TNF-α, IL-1β, and IL-6 in the lung homogenates of the hyperoxia group than in the normoxia group (P ≤ 0.01, 0.001, and 0.001, respectively). Myeloperoxidase and protein carbonyls (PC) were higher (P = 0.03 and P = 0.01, respectively) and superoxide dismutase (SOD) was lower in the lung homogenates of the hyperoxia group (P ≤ 0.001). Higher myeloperoxidase, PC, and cytokine levels, and lower SOD availability indicate a greater degree of injury in the lungs of the hyperoxia animals, possibly from using 100% oxygen. In this translational study using a pig model, FiO(2)  ≤ 50% during OLV reduced hyperoxic injury and improved function in the lungs. Pediatr Pulmonol. 2012. 47:979-986. © 2012 Wiley Periodicals, Inc.
    No preview · Article · Oct 2012 · Pediatric Pulmonology
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    ABSTRACT: Background: Acute inflammatory responses to supplemental oxygen and mechanical ventilation have been implicated in the pathophysiological sequelae of respiratory distress syndrome (RDS). Although surfactant replacement therapy (SRT) has contributed to lung stability, the effect on lung inflammation is inconclusive. Lucinactant contains sinapultide (KL4), a novel synthetic peptide that functionally mimics surfactant protein B, a protein with anti-inflammatory properties. We tested the hypothesis that lucinactant may modulate lung inflammatory response to mechanical ventilation in the management of RDS and may confer greater protection than animal-derived surfactants. Methods: Preterm lambs (126.8 ± 0.2 SD d gestation) were randomized to receive lucinactant, poractant alfa, beractant, or no surfactant and studied for 4 h. Gas exchange and pulmonary function were assessed serially. Lung inflammation biomarkers and lung histology were assessed at termination. Results: SRT improved lung compliance relative to no SRT without significant difference between SRT groups. Lucinactant attenuated lung and systemic inflammatory response, supported oxygenation at lower ventilatory requirements, and preserved lung structural integrity to a greater degree than either no SRT or SRT with poractant alfa or beractant. Conclusion: These data suggest that early intervention with lucinactant may more effectively mitigate pulmonary pathophysiological sequelae of RDS than the animal-derived surfactants poractant alfa or beractant.
    Full-text · Article · Jul 2012 · Pediatric Research
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    ABSTRACT: Background: We have demonstrated effectiveness of an aerosolized, peptide-containing, synthetic surfactant (KL4 surfactant), in spontaneously breathing CPAP-supported preterm lambs. Dose-ranging studies are required to define the dose that produces optimal physiologic and biomarker responses.
    Full-text · Article · Nov 2011 · Pediatric Research
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    ABSTRACT: Preterm infants lack necessary thermoregulation. An ideal incubator should maintain a uniform and constant thermal environment. We compared the effectiveness of a supplemental heating blanket to improve the heating characteristics of two different incubator warming devices using assessment of their respective function alone as controls. Device A and device B, with and without a heating blanket (Harvard Apparatus), were instrumented with a distribution matrix of multiple temperature (n = 11) and humidity probes. These data were serially measured during warm up to 37.5 °C and through a series of open-door perturbations. The time constant, temperature variation, and change in air temperature were calculated. Data were analyzed for significance by 2-factor ANOVA for each respective incubator either turned on or off with either the heating blanket turned on or off. Device A warms faster (33.87% ; p < 0.05) than device B, but has a greater (37.27% ; p < 0.05) temperature variation during warmup. The heating blanket enhances the thermal response of device A during warmup, but does not alter those of device B. With the side door open, device A shows a smaller (-16.5% ; p < 0.05) temperature variation than device B; the heating blanket attenuates the temperature change in both devices. These results demonstrate that the use of a supplemental heating blanket, as well as device-related differences, may impact clinical control of a thermal environment.
    No preview · Article · Nov 2010 · Biomedical Instrumentation & Technology

  • No preview · Conference Paper · May 2010
  • R. Lindemann · T.L. Hubert · J. Wu · C. Agnew · Shaffer · M.R. Wolfson
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    ABSTRACT: Objective: Underdeveloped thermoregulatory capability predisposes the preterm infant to metabolic instability. An ideal incubator environment should reduce thermal challenges of routine care. We compared the thermal responses of the newborn pig to clinical manipulations in 2 incubators and the impact of a heating blanket on these responses. Design: Anesthetized, paralyzed, and ventilated newborn pigs were randomized to pre-warmed Caleo® or Giraffe® Omnibed®, with or without a heating blanket, and subjected to warmup and a series of open door perturbations. The temperature variation, time constant, and change in skin temperature were calculated and analyzed by 2-factor analysis of variance. Results: There were no differences between the incubators during warm-up; incubator plus heating blanket decreased the time constant, independent of device. With the side access door open, the change in skin temperature was less in the Caleo®; the heating blanket attenuated the change in skin temperature in both devices. Conclusion: These data demonstrate device and clinical manipulation-dependent differences in the thermal responses of the newborn pig.
    No preview · Article · Jan 2010