Evaluation and Monitoring of Pulmonary Hypertension in Neonates With Congenital Diaphragmatic Hernia

Mejia, Aura A Sanchez; Rodgers, Nathan

doi:10.1007/s11936-019-0711-x

Cited by 15 publications

(11 citation statements)

References 68 publications

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“…Contributing centers ascertained CDH-PH severity by measuring the peak velocity of the tricuspid regurgitation jet to estimate systolic pulmonary artery pressure relative to systemic systolic blood pressure. This technique was utilized because it is both the most consistently reported method for defining CDH-PH and the most pragmatic method for collecting CDH-PH data from multiple international institutions [17][18][19]. While numerous other indices for assessing PH have been reported, their reproducibility is unknown [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia

et al. 2021

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Introduction: Pulmonary hypertension (PH) is the major pathophysiologic consequence of congenital diaphragmatic hernia (CDH). We aimed to evaluate the association between early CDH-associated PH (CDH-PH) and inpatient outcomes. Methods: The CDH Study Group registry was queried for infants born 2015–2019 with echocardiograms before 48h of life. PH was categorized using echocardiographic findings: none, mild (right ventricular systolic pressure <2/3 systemic), moderate (between 2/3 systemic and systemic), or severe (supra-systemic). Univariate and multivariate analyses were performed. Adjusted Poisson regression was used to assess the primary composite outcome of mortality or oxygen support at 30 days. Results: Of 1,472 patients, 86.5% had CDH-PH: 13.9% mild (n = 193), 44.4% moderate (n = 631), and 33.2% severe (n = 468). On adjusted analysis, the primary outcome of mortality or oxygen support at 30 days occurred more frequently in infants with moderate (incidence rate ratio [IRR] 1.8, 95% confidence interval [CI], 1.2–2.6) and severe CDH-PH (IRR 2.0, 95% CI, 1.3–2.9). Extracorporeal life support (ECLS) utilization was associated only with severe CDH-PH after adjustment (IRR 1.8, 95% CI, 1.0–3.3). Discussion/Conclusion: Early, postnatal CDH-PH is independently associated with increased risk for mortality or oxygen support at 30 days and utilization of ECLS. Early echocardiogram is a valuable prognostic tool for early, inpatient outcomes in neonates with CDH.

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Section: Discussionmentioning

confidence: 99%

Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia

et al. 2021

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“…Parents of infants born with a congenital disease with a high risk of mortality (1–5) have been found to want to receive psychosocial counseling (8), including information about the treatment process after the infant's birth. In addition, it is important to provide regular information about the infant's condition and the mother should be supported by a multidisciplinary team (pediatric surgeon, nurse, dietitian, psychologist, etc.)…”

Section: Resultsmentioning

confidence: 99%

“…In addition, it is important to provide regular information about the infant's condition and the mother should be supported by a multidisciplinary team (pediatric surgeon, nurse, dietitian, psychologist, etc.) (1)(2)(3)(4)(5). Nurses should remain with their mothers from the moment a prenatal diagnosis is made (9,10).…”

Section: Lessons Learnedmentioning

confidence: 99%

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Living With My Baby With Congenital Anomaly: A Qualitative Case Report

Özlü

Vural

Dökümcü

2022

Journal of Patient Experience

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This case report was made to understand the emotions, thoughts, and experiences of the mother, who was lying in the long-term neonatal intensive care unit. An individual in-depth interview was conducted once with the mother of the infant with the diaphragm hernia. The interview recorded and lasted approximately 30 min. The data were analyzed by inductive method and themes and codes were created. The mother of the infant with a diaphragmatic hernia was 31 years old, married with 2 children, and employed full-time. The infant was diagnosed antenatally at 37 weeks old, weighed 3.000 g, and was male. As a result of the interview, 3 main themes were identified: “Facing the disease,” “Experiences in intensive care,” and “Change in family life.” The results show that having an infant with congenital anomaly affects the life of all family members and shows the problems experienced strikingly.

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“…Pulmonary hypertension occurs in 30%-50% of CDH newborns and should be screened for and managed by repeated cardiac ultrasound. 50 Persistent severe pulmonary hypertension at 3 months of age is correlated with a more than 50% discharge mortality. 51 Treatment of pulmonary hypertension is challenging.…”

Section: Neonatal Resuscitation What Will Happen At Birth?mentioning

confidence: 99%

What should we tell parents? Congenital diaphragmatic hernia

et al. 2021

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Congenital diaphragmatic hernia (CDH) is characterized by a defect in the muscle dividing the thoracic and abdominal cavities. This leads to herniation of the abdominal organs into the thorax and a disturbance of lung development. Two‐thirds of cases are identified by prenatal ultrasound in the second trimester, which should prompt referral to a tertiary center for prognosis assessment and counseling by a multidisciplinary team familiar with this condition. In this review, we summarize evidence on prenatal diagnosis and postnatal management of CDH. There is a focus on information that should be provided to expecting parents during prenatal counseling.

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Evaluation and Monitoring of Pulmonary Hypertension in Neonates With Congenital Diaphragmatic Hernia

Cited by 15 publications

References 68 publications

Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia

Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia

Living With My Baby With Congenital Anomaly: A Qualitative Case Report

What should we tell parents? Congenital diaphragmatic hernia

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