Management and experience of postural placement in postoperative mechanical ventilation of newborns

Wu, Qiong; Liu, Juan; Liu, Yue; Jiang, Yongfeng

doi:10.21037/apm-20-1003

Cited by 2 publications

(6 citation statements)

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“…Prone positioning of mechanically ventilated infants post-operative repair of CDH has been associated with an improvement in oxygenation (PaO 2 /FiO 2 ratio) (p = 0.032) and a reduction in the alveolar-arterial oxygen difference (p = 0.043) (29). Limitations of that study, however, were that measures of oxygenation and respiratory function were only measured for 30 min in each position and were not related to the adverse longer-term pulmonary outcomes suffered by infants with CDH.…”

Section: Ventilatory Management Post-surgical Repairmentioning

confidence: 99%

Respiratory Support of Infants With Congenital Diaphragmatic Hernia

Williams

Greenough

2021

Front. Pediatr.

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Optimisation of respiratory support of infants with congenital diaphragmatic hernia (CDH) is critical. Infants with CDH often have severe lung hypoplasia and abnormal development of their pulmonary vasculature, leading to ventilation perfusion mismatch. It is vital that lung protective ventilation strategies are employed during both initial stabilisation and post-surgical repair to avoid ventilator induced lung damage and oxygen toxicity to prevent further impairment to an already diminished gas-exchanging environment. There is a lack of robust evidence for the routine use of surfactant therapy during initial resuscitation of infants with CDH and thus administration cannot be recommended outside clinical trials. Additionally, inhaled nitric oxide has been shown to have no benefit in reducing the mortality rates of infants with CDH. Other therapeutic agents which beneficially act on pulmonary hypertension are currently being assessed in infants with CDH in randomised multicentre trials. The role of novel ventilatory modalities such as closed loop automated oxygen control, liquid ventilation and heliox therapy may offer promise for infants with CDH, but the benefits need to be determined in appropriately designed clinical trials.

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Section: Ventilatory Management Post-surgical Repairmentioning

confidence: 99%

Respiratory Support of Infants With Congenital Diaphragmatic Hernia

Williams

Greenough

2021

Front. Pediatr.

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“…Excluded studies were duplicates, abstract‐only papers, manuscripts published before year 2000, those not in the English language, animal studies, and those describing pre‐natal CDH interventions. We included 27 studies 13–39 of which 13 were RCTs 13–25 and 14 articles were observational studies 26–39 . Figure 2 shows the PRISMA flowchart for the study review.…”

Section: Resultsmentioning

confidence: 99%

“…When scrutinising publications and comparing the outcomes that were measured to those reported, we did uncover some evidence of selective reporting bias. For example, various RCTs did not report measurements on vital clinical signs despite specifying these as an outcome measure 16,25 …”

Section: Discussionmentioning

confidence: 99%

“…• There is great need for international consensus on CDH outcome reporting. of which 13 were RCTs [13][14][15][16][17][18][19][20][21][22][23][24][25] and 14 articles were observational studies. [26][27][28][29][30][31][32][33][34][35][36][37][38][39] Figure 2 shows the PRISMA flowchart for the study review.…”

Section: Key Notesmentioning

confidence: 99%

“…Overall, the studies included 2596 CDH patients. The mean number of index CDH patients was 96 per publication (range 5-691); 13/27 studies were RCTs, [13][14][15][16][17][18][19][20][21][22][23][24][25] and 14/27 were observational studies [26][27][28][29][30][31][32][33][34][35][36][37][38][39] ; 7/27 studies were multicentre collaborative works. Studies emerged from a variety of countries worldwide including the UK, Netherlands, Belgium, USA, Canada, Japan, Egypt, and Australia.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Clinical trials and outcome reporting in congenital diaphragmatic hernia overlook long‐term health and functional outcomes—A plea for core outcomes

2022

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Aim To review the selection, measurement and reporting of outcomes in studies of interventions in Congenital Diaphragmatic Hernia (CDH). Methods We searched the Cochrane Central Register of Controlled Trials from 2000–2020 for randomised trials and observational studies. Outcomes reported were classified into seven key domains modelled on the patient journey. Results Our search yielded 118 papers; 27 were eligible. The most frequent domains measured were ‘short‐term markers of disease activity’ (17/27), whereas long‐term outcomes (3/27) and outcomes relating to functional health status (8/27) were reported infrequently. There was heterogeneity in the methods and timing of outcome reporting. Primary outcomes were varied and not always clearly stated. Conclusion Long‐term health and functional outcomes involving interventional studies in CDH are infrequently reported, which hinders the process of shared decision‐making and evidence‐based healthcare. A CDH core outcome set is needed to standardise outcome reporting that is relevant to both families and healthcare teams.

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Management and experience of postural placement in postoperative mechanical ventilation of newborns

Cited by 2 publications

References 0 publications

Respiratory Support of Infants With Congenital Diaphragmatic Hernia

Respiratory Support of Infants With Congenital Diaphragmatic Hernia

Clinical trials and outcome reporting in congenital diaphragmatic hernia overlook long‐term health and functional outcomes—A plea for core outcomes

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