Management of infants with congenital diaphragmatic hernia and pulmonary hypertension—one size does not fit all

Greenough, Anne

doi:10.1038/s41390-023-02551-z

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…Postnatal management generally involves stabilization of the newborn's condition followed by surgical repair of the diaphragmatic defect. However, the complexity and variability of CDH often necessitate a multidisciplinary approach at specialized care centers [113,115]. The severity of the disorder, associated anomalies, and the presence of pulmonary hypertension significantly affect prognosis, further underscoring the critical need for specialized, expert care in managing this condition [23,110].…”

Section: Congenital Diaphragmatic Hernia (Cdh)mentioning

confidence: 99%

Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review

Yaremenko,

Pechnikova,

Porpodis

et al. 2024

JPM

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Fetal lung development is a crucial and complex process that lays the groundwork for postnatal respiratory health. However, disruptions in this delicate developmental journey can lead to fetal lung development disorders, impacting neonatal outcomes and potentially influencing health outcomes well into adulthood. Recent research has shed light on the intriguing association between fetal lung development disorders and the development of adult diseases. Understanding these links can provide valuable insights into the developmental origins of health and disease, paving the way for targeted preventive measures and clinical interventions. This review article aims to comprehensively explore the association of fetal lung development disorders with adult diseases. We delve into the stages of fetal lung development, examining key factors influencing fetal lung maturation. Subsequently, we investigate specific fetal lung development disorders, such as respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), congenital diaphragmatic hernia (CDH), and other abnormalities. Furthermore, we explore the potential mechanisms underlying these associations, considering the role of epigenetic modifications, transgenerational effects, and intrauterine environmental factors. Additionally, we examine the epidemiological evidence and clinical findings linking fetal lung development disorders to adult respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and other respiratory ailments. This review provides valuable insights for healthcare professionals and researchers, guiding future investigations and shaping strategies for preventive interventions and long-term care.

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Section: Congenital Diaphragmatic Hernia (Cdh)mentioning

confidence: 99%

Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review

Yaremenko,

Pechnikova,

Porpodis

et al. 2024

JPM

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Utility of the oxygenation index in management of congenital diaphragmatic hernia: a report from a Thai University Surgical Centre

Kulngamnetr,

Pongmee,

Losty

et al. 2024

Pediatr Surg Int

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Background Oxygenation index (OI) is associated with severity of newborn pulmonary hypertension (PH) in congenital diaphragmatic hernia (CDH). Higher OI may indicate worst degree(s) of PH. Objectives This study reports OI dynamic(s) over the first 72 h of life and its correlation with (1) perioperative morbidity and (2) CDH mortality. Methods Medical records of inborn CDH babies during 2002–2022 were examined. OI on Days (s) 1–3 and perioperative OI trends were recorded. Operation (primary vs patch repair) and survival rates (%) were studied. Results Fifty-five CDH newborns (54.5% male: 45.5% female)—mean birth GA 37.5 ± 2.7 wks. had a mean birth weight 2813 ± 684 g with prenatal diagnosis in 32.7% cases. 52/55 (94.5%) were intubated at birth and HFOV deployed in 29 (55.8%). Those requiring HFOV had higher OI on DOL1 (24.8 ± 17 vs 10.3 ± 11.5; p < 0.05), DOL 2 (26.3 ± 22.9 vs 6.7 ± 12.1; p < 0.05) and DOL 3 (21.9 ± 33.8 vs 5.5 ± 9.3; p = 0.04). Operation was undertaken in 36/55 (65.5%). Preoperative mortality group had significant higher OI on DOL 2 (42.1 ± 21.0 vs 14.9 ± 9.3; p = 0.04). CDH defects were—Type A N = 27 (75%), Type B N = 7 (19.4%) and Type C N = 2 (5.6%). Overall mortality was 40% (22/55). Statistically significant OI trends were recorded in non-survival vs. survival groups on DOL 1 (31.6 ± 16.8. vs 10.5 ± 9.0; p < 0.05, DOL 2 (38.1 ± 21.9 vs 6.3 ± 7.1; p < 0.05), and DOL 3 (38.8 ± 39.4; p = 0.012). Conclusions OI dynamics are highly predictive for accurate monitoring of CDH cardiorespiratory physiology and crucially may guide ventilatory management as well as timing of surgery.

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Echocardiography in the neonatal unit: current status and future prospects

Singh

2024

Expert Review of Medical Devices

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Management of infants with congenital diaphragmatic hernia and pulmonary hypertension—one size does not fit all

Cited by 5 publications

References 14 publications

Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review

Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review

Utility of the oxygenation index in management of congenital diaphragmatic hernia: a report from a Thai University Surgical Centre

Echocardiography in the neonatal unit: current status and future prospects

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