Lung function over the first 3 years of life in children with congenital diaphragmatic hernia

Panitch, Howard B.; Weiner, Daniel J.; Feng, Rui; Perez, Myrza R.; Healy, Fiona; McDonough, Joseph M.; Rintoul, Natalie E.; Hedrick, Holly L.

doi:10.1002/ppul.23082

Cited by 44 publications

(37 citation statements)

References 36 publications

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“…Trachsel et al 21 has found a history of pneumonia in 35% and Okuyama et al 19 in 26% of CDH survivors. Little is known about the etiology and natural course of these respiratory problems, which could have the potential to influence the quality of life of survivors of CDH into adulthood 22 . The etiology can be related to the embryology of the CDH, early postnatal therapy (ventilation, nutrition) and also the surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

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Abnormalities in pulmonary function in infants with high-risk congenital diaphragmatic hernia

Rygl¹,

Rounova²,

Jan³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. The aim of the study was to analyze lung growth and abnormality of infant pulmonary function tests (IPFT) in congenital diaphragmatic hernia (CDH) survivors younger than three years of age with respect to unfavorable prognostic factors. Methods. Thirty high-risk CDH survivors at the age of 1.32±0.54 years, body weight 9.76±1.25 kg were examined using IPFT: tidal breathing analysis, baby resistance/compliance, whole baby body plethysmography and rapid thoracoabdominal compression. Gore-Tex patch was used in 13% of patients (GORE group). Pulmonary hypertension was diagnosed and managed in 13% (iNO group). Standard protocols and appropriate reference values were used and obtained data were statistically analysed. Results. High incidence of peripheral airway obstruction (70%), increased value of functional residual capacity (FRC p ) 191.3±24.5 mL (126.5±36.9 % predicted; P < 0.0005), increased value of effective airway resistance (R eff ) 1.71±0.93 kPa.L -1 .s (144.4±80.1 % predicted; P < 0.01) and decreased specific compliance of the respiratory system (C rs /kg) 14.1±2.3 mL.kPa.kg -1 (i.e., 76.1±20.1 % predicted, P < 0.0005) was noted in infants with CDH in comparison with reference values. Increased value of FRC p was found in GORE group (165.7±51.9 versus 120.4±31.2, P < 0.02) and in iNO group (183.1±52.6 versus 117.8±25.7 mL; P < 0.0005). Conclusion. A high incidence of peripheral airway obstruction, an increased value of FRC p and decreased specific compliance of the respiratory system was noted in infants with CDH. Unfavorable prognostic factors (Gore-Tex patch, pulmonary hypertension) correlate with more severe alteration of pulmonary function in infants.

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Section: Discussionmentioning

confidence: 99%

“…Panitch et al analysed serial IFPT of 98 infants with CDH on 1-5 occasions using the raised volume rapid thoracic compression technique 22 . Forced expiratory flows were below normal.…”

Section: Discussionmentioning

confidence: 99%

Abnormalities in pulmonary function in infants with high-risk congenital diaphragmatic hernia

Rygl¹,

Rounova²,

Jan³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…We also assessed breathing pattern but did not detect differences between the three groups. Conversely, children with CDH exhibit mild obstructive airway disease and have hyperdistended lungs at the age of 3 and older (Ijsselstijn, Tibboel, Hop, Molenaar, & de Jongste, ; Panitch et al, ). Obviously, these children have underlying hypoplasia, yet there is limited clinical data of the impact of different patches on pulmonary function.…”

Section: Discussionmentioning

confidence: 99%

Providing direction improves function: Comparison of a radial pore-orientated acellular collagen scaffold to clinical alternatives in a surgically induced rabbit diaphragmatic tissue defect model

Eastwood

Daamen

Joyeux

et al. 2018

J Tissue Eng Regen Med

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Gore-Tex® is a widely used durable patch for repair of congenital diaphragmatic defects yet may result in complications. We compared Gore-Tex with a composite of a radial pore-orientated collagen scaffold (RP-Composite) and clinically used porcine small intestinal submucosa (SIS; Surgisis®) in a rabbit model for diaphragmatic hernia. The growing rabbit mimics the rapid rib cage growth and reherniation rates seen in children. We created and immediately repaired left hemidiaphragmatic defects in 6-week-old rabbits with Gore-Tex, SIS, and an RP-Composite scaffold. An additional group of rabbits had a sham operation. At 90 days, survivors more than doubled in weight. We observed few reherniations or eventrations in Gore-Tex (17%) and RP-Composite (22%) implanted animals. However, SIS failed in all rabbits. Maximum transdiaphragmatic pressure was lower in Gore-Tex (71%) than RP-Composite implanted animals (112%) or sham (134%). Gore-Tex repairs were less compliant than RP-Composite, which behaved as sham diaphragm (p < 0.01). RP-Composite induced less foreign body giant cell reaction than Gore-Tex (p < 0.05) with more collagen deposition (p < 0.001), although there was a tendency for the scaffold to calcify. Unlike Gore-Tex, the compliance of diaphragms reconstructed with RP-Composite scaffolds were comparable with native diaphragm, whereas reherniation rates and transdiaphragmatic pressure measurements were similar.

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“…It is intriguing to consider the durable impact of severe ipsilateral lung growth restriction at the cellular or molecular level in regard to poor tissue perfusion and possible loss of acinar precursors as long‐term studies suggest that the post‐repair expansion of the ipsilateral lung is the result of alveolar overdistention rather than hyperplasia . Additionally, the significant visceral herniation in cases of severe CDH may place similar limitations on perfusion leading to an analogous compromise in the capacity for long‐term growth and acinar development of the contralateral lung . Lastly, contralateral lung growth in the third trimester was greatest in the absence of liver herniation (group 1) leading to an increase in the contralateral lung volume at late gestation (o/e LV‐R) and potentially the capacity for further long‐term growth and alveolar development.…”

Section: Discussionmentioning

confidence: 99%

Differential patterns of prenatal ipsilateral and contralateral lung growth in cases of isolated left-sided congenital diaphragmatic hernia

et al. 2015

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Lung function over the first 3 years of life in children with congenital diaphragmatic hernia

Cited by 44 publications

References 36 publications

Abnormalities in pulmonary function in infants with high-risk congenital diaphragmatic hernia

Abnormalities in pulmonary function in infants with high-risk congenital diaphragmatic hernia

Providing direction improves function: Comparison of a radial pore-orientated acellular collagen scaffold to clinical alternatives in a surgically induced rabbit diaphragmatic tissue defect model

Differential patterns of prenatal ipsilateral and contralateral lung growth in cases of isolated left-sided congenital diaphragmatic hernia

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