Implications of Atrial-Level Shunting by Echocardiography in Newborns with Congenital Diaphragmatic Hernia

Wehrmann, Melissa; Patel, Sonali S.; Haxel, Caitlin; Cassidy, Courtney; Howley, Lisa; Cuneo, Bettina F.; Gien, Jason; Kinsella, John P.

doi:10.1016/j.jpeds.2019.12.037

Cited by 23 publications

(21 citation statements)

References 24 publications

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“…Additional relevant data were provided by one author [34]. Finally, 11 studies were included in this review (Table 1) [33,34,[36][37][38][39][40][41][42][43][44]. Fig.…”

Section: Search Resultsmentioning

confidence: 99%

“…Of the 11 studies [33,34,[36][37][38][39][40][41][42][43][44], ten had a retrospective design, and one had a prospective cohort design. Among the multicenter studies, one was a registry-based international CDHSG collaboration [42].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Two studies reported RV function [38,39], four reported LV function [33,34,37,43], and ve reported both RV and LV function [36,[40][41][42]44]. Two studies de ned LVD a priori [33,41]. LVD [34] and RV dysfunction (RVD) [38] were de ned based on ROC curve analysis in two studies.…”

Section: Prognostic Factorsmentioning

confidence: 99%

“…Nine studies reported the association of VF (any reported VF measurement) with survival [33,34,[36][37][38][39][40][41][42]. Four studies with 899 participants (range, 51-674), including 856 who survived, were pooled.…”

Section: Findings LV Function and Survivalmentioning

confidence: 99%

“…Dao et al included only low-risk CDH cases (type A and B) [42]. Wehrmann et al [41] exclusively studied patients with measurable right-to-left or left-to-right atrial shunts. Lawrence et al limited their analysis to iNO-treated CDH [33].…”

Section: Participants' Characteristicsmentioning

confidence: 99%

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Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Prasad

Saha²,

Kumar

2021

Preprint

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There is emerging evidence supporting ventricular function as a prognostic factor in congenital diaphragmatic hernia (CDH). The present systematic review and meta-analysis aimed to determine the predictive value of early ventricular function for survival and extracorporeal membrane oxygenation (ECMO) requirement in newborns with CDH. PubMed, Google Scholar, Cochrane Central Register, Clinical Trial Registry, and Opengrey were accessed. Studies evaluating associations between echocardiographic ventricular function measured ≤ 48 h after birth and survival or ECMO requirement were included. Two independent authors extracted the following data: study and participant characteristics, prognostic factors, and outcome-related data. Eleven studies met the inclusion criteria. Five studies reported on survival, two on ECMO, and four on both outcomes. A moderate risk of bias was found in most of the studies, mainly because of selection, prognostic factors, and confounding biases. For survival (899 participants), pooled sensitivity and specificity were 86% (95% confidence interval [CI], 77–92%) and 44% (95% CI, 25–65%), respectively, in normal left ventricular function. For ECMO need (815 participants), pooled sensitivity and specificity were 39.8% (95% CI, 27–52%) and 88% (95% CI, 80–96%), respectively, in left ventricular dysfunction. Overall certainty of the evidence was graded very low for survival and low for ECMO. Inconsistent reporting of echocardiographic measurements and lack of adjustment for confounding factors were major limitations. Conclusions: Early ventricular dysfunction is a potential prognostic factor in CDH. Standardized echocardiographic measurement reporting and high-quality studies are needed to further elucidate its prognostic significance.

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“…Additional relevant data were provided by one author [34]. Finally, 11 studies were included in this review (Table 1) [33,34,[36][37][38][39][40][41][42][43][44]. Fig.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Prognostic Factorsmentioning

confidence: 99%

Section: Findings LV Function and Survivalmentioning

confidence: 99%

Section: Participants' Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Prasad

Saha²,

Kumar

2021

Preprint

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Impact of fetal treatments for congenital diaphragmatic hernia on lung development

Dahl

Lavizzari

Davis

et al. 2022

The Anatomical Record

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The extent of lung hypoplasia impacts the survival and severity of morbidities associated with congenital diaphragmatic hernia (CDH). The alveoli of CDH infants and in experimental models of CDH have thickened septa with fewer type II pneumocytes and capillaries. Fetal treatments of CDH‐risk preterm birth. Therefore, treatments must aim to balance the need for increased gas exchange surface area with the restoration of pulmonary epithelial type II cells and the long‐term respiratory and neurodevelopmental consequences of prematurity. Achievement of sufficient lung development in utero for successful postnatal transition requires adequate intra‐thoracic space for lung growth, maintenance of sufficient volume and appropriate composition of fetal lung fluid, regular fetal breathing movements, appropriate gas exchange area, and ample surfactant production. The review aims to examine the rationale for current and future therapeutic strategies to improve postnatal outcomes of infants with CDH.

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Ventricular function in congenital diaphragmatic hernia: a systematic review and meta-analysis

2021

View full text Add to dashboard Cite

Implications of Atrial-Level Shunting by Echocardiography in Newborns with Congenital Diaphragmatic Hernia

Cited by 23 publications

References 24 publications

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Impact of fetal treatments for congenital diaphragmatic hernia on lung development

Ventricular function in congenital diaphragmatic hernia: a systematic review and meta-analysis

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