Inhaled Nitric Oxide Is Associated with Improved Oxygenation in a Subpopulation of Infants with Congenital Diaphragmatic Hernia and Pulmonary Hypertension

Lawrence, Kendall M.; Monos, Stylianos; Adams, Sherrill L.; Herkert, Lisa M.; Peranteau, William H.; Munson, David; Hopper, Rachel K.; Avitabile, Catherine M.; Rintoul, Natalie E.; Hedrick, Holly L.

doi:10.1016/j.jpeds.2019.09.052

Cited by 49 publications

(27 citation statements)

References 27 publications

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“…It is known that not all patient with congenital diaphragmatic hernia (CDH) respond successfully to iNO and its use is discouraged, based on the results of the NINOS trial, in which an increased mortality and ECMO requirement was observed in the iNOtreated patients (35). However, a recent study showed that the non-response to iNO in patients with CDH might be related to the presence of LV failure (36). Hypoplasia or myocardial dysfunction of the LV is more often observed in newborn infants with CDH.…”

Section: Persistent Pulmonary Hypertension Of the Newbornmentioning

confidence: 99%

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Individualized Hemodynamic Management in Newborns

Boode¹

2020

Front. Pediatr.

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In our aim to improve patient outcome we are transitioning from a "one-size-fits-all" protocolized approach toward an individualized hemodynamic management, that is tailored to the cardiovascular (patho-)physiology and the specific clinical characteristics of each individual patient. In this narrative review an overview is provided about an individualized approach toward various neonatal hemodynamic conditions.

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Section: Persistent Pulmonary Hypertension Of the Newbornmentioning

confidence: 99%

“…Decreasing pulmonary vascular resistance with iNO will augment pulmonary venous return, that might further deteriorate LV function. It was concluded that iNO treatment improved oxygenation and reduced the need for support with ECMO in CDH patients with preserved LV systolic function (36).…”

Section: Persistent Pulmonary Hypertension Of the Newbornmentioning

confidence: 99%

Individualized Hemodynamic Management in Newborns

Boode¹

2020

Front. Pediatr.

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“…Lawrence та співавт. (2020), зокрема, поліпшення рівня PaO2, альвеолярно артеріального градієнту та зменшення частоти показів для проведення ЕСМО [25]. Подібні результати представлені німецькими дослідни ками у 2019 р.: за умови застосування iNO у дітей з ВДК зменшується потреби в підтримці ECMO (p=0,0054), подовжується час до ініцію вання ECMO (p=0,005) та скорочується рівень смертності (p=0,0396).…”

Section: результатиunclassified

International recommendations on neonatal management with congenital diaphragmatic hernia: literature review

Babintseva¹,

Godovanets²,

Khodzinska³

et al. 2021

MPU

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Congenital diaphragmatic hernia (CDH) is a defect of diaphragm development which is characterized by herniation of the abdominal content into the chest resulting in pulmonary hypoplasia and pulmonary hypertension of various degrees. Mortality and sickness rates among survived children with this pathology remain high all over the world. Prenatal diagnostics of high quality will help to find neonates with severe CDH and promote mobilization of human and material resources for optimal management at the tertiary level of giving medical aid. Attention of specialists in prenatal ultrasound diagnostics should be drawn to the necessity of measuring observed/expected lung(to(head ratio and location of the liver in fetus. Optimal treatment of neonates during preoperative period is focused on mild ventilation, avoidance of oxygen toxicity, baro/volutrauma of a hypoplastic lung and cardiac support. Administration of pulmonary vasodilator therapy including inhaled nitric oxide and extracorporal membrane oxygenation is pathogenetically substantiated for patients with pulmonary hypertension, and surgical correction should be delayed till stabilization of patient's condition. Echocardiography is a critically important diagnostic method. It enables to determine severity of pulmonary hypertension and myocardial functional disorders, to find targeted systemic methods of treatment that improve hemodynamic function or decrease pulmonary vascular resistance. Considering an insufficient level of evidence of the existing international recommendations, large(scale multi(center randomized studies on investigation of the best methods to prevent, diagnose and treat neonates with CDH are essential. No conflict of interest was declared by the authors. Key words: congenital diaphragmatic hernia; neonate; lung-to-head ratio; pulmonary hypertension; extracorporal membrane oxygenation.

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“…46 Some centers have experienced an association with improved oxygenation and a decrease in ECMO use. 47 Yet, following the evidence, INO is difficult to recommend, although it may have a limited role in treating severe hypoxemia to enable safer transport or ECMO initiation.…”

Section: Congenital Diaphragmatic Herniamentioning

confidence: 99%

Inhaled Pulmonary Vasodilators in the Neonatal and Pediatric ICU

Walsh

2020

Respir Care

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Inhaled Nitric Oxide Is Associated with Improved Oxygenation in a Subpopulation of Infants with Congenital Diaphragmatic Hernia and Pulmonary Hypertension

Cited by 49 publications

References 27 publications

Individualized Hemodynamic Management in Newborns

Individualized Hemodynamic Management in Newborns

International recommendations on neonatal management with congenital diaphragmatic hernia: literature review

Inhaled Pulmonary Vasodilators in the Neonatal and Pediatric ICU

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