Left ventricular cardiac output is a reliable predictor of extracorporeal life support in neonates with congenital diaphragmatic hernia

Gaffar, Sharib; Ellini, Ahmad R; Ahmad, Irfan; Chen, Yanjun; Ashrafi, Amir H

doi:10.1038/s41372-019-0348-3

Cited by 20 publications

(10 citation statements)

References 16 publications

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“…Additional relevant data were provided by one author [34]. Finally, 11 studies were included in this review (Table 1) [33,34,[36][37][38][39][40][41][42][43][44]. Fig.…”

Section: Search Resultsmentioning

confidence: 99%

“…Of the 11 studies [33,34,[36][37][38][39][40][41][42][43][44], ten had a retrospective design, and one had a prospective cohort design. Among the multicenter studies, one was a registry-based international CDHSG collaboration [42].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Six studies reported an association between LV function and ECMO requirement [33,[40][41][42][43][44]. Three studies (111 out of 815 participants requiring ECMO) could be pooled for meta-analysis [33,41,42].…”

Section: Vf and Ecmo Requirementmentioning

confidence: 99%

“…There were signi cant variations in echocardiographic parameters among studies (Table 2). Two studies reported RV function [38,39], four reported LV function [33,34,37,43], and ve reported both RV and LV function [36,[40][41][42]44]. Two studies de ned LVD a priori [33,41].…”

Section: Prognostic Factorsmentioning

confidence: 99%

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Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Prasad

Saha²,

Kumar

2021

Preprint

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There is emerging evidence supporting ventricular function as a prognostic factor in congenital diaphragmatic hernia (CDH). The present systematic review and meta-analysis aimed to determine the predictive value of early ventricular function for survival and extracorporeal membrane oxygenation (ECMO) requirement in newborns with CDH. PubMed, Google Scholar, Cochrane Central Register, Clinical Trial Registry, and Opengrey were accessed. Studies evaluating associations between echocardiographic ventricular function measured ≤ 48 h after birth and survival or ECMO requirement were included. Two independent authors extracted the following data: study and participant characteristics, prognostic factors, and outcome-related data. Eleven studies met the inclusion criteria. Five studies reported on survival, two on ECMO, and four on both outcomes. A moderate risk of bias was found in most of the studies, mainly because of selection, prognostic factors, and confounding biases. For survival (899 participants), pooled sensitivity and specificity were 86% (95% confidence interval [CI], 77–92%) and 44% (95% CI, 25–65%), respectively, in normal left ventricular function. For ECMO need (815 participants), pooled sensitivity and specificity were 39.8% (95% CI, 27–52%) and 88% (95% CI, 80–96%), respectively, in left ventricular dysfunction. Overall certainty of the evidence was graded very low for survival and low for ECMO. Inconsistent reporting of echocardiographic measurements and lack of adjustment for confounding factors were major limitations. Conclusions: Early ventricular dysfunction is a potential prognostic factor in CDH. Standardized echocardiographic measurement reporting and high-quality studies are needed to further elucidate its prognostic significance.

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“…Additional relevant data were provided by one author [34]. Finally, 11 studies were included in this review (Table 1) [33,34,[36][37][38][39][40][41][42][43][44]. Fig.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Vf and Ecmo Requirementmentioning

confidence: 99%

Section: Prognostic Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Prasad

Saha²,

Kumar

2021

Preprint

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“…Up to 30-40% of newborns with CDH can have left (LV) or right ventricular (RV) or biventricular dysfunction, and ventricular interdependence may play a role [17,18]. Association of ventricular dysfunction and ventricular performance is not only a predictor for disease severity [19] but also for mortality [20] and need for ECMO [21].…”

Section: Introductionmentioning

confidence: 99%

The Utility of serial Echocardiography parameters in the Management of newborns with Congenital `Diaphragmatic Hernia (CDH) and predictors of Mortality

Soni

Chakkarapani

et al. 2022

Preprint

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Objective: Ventricular dysfunction may be found in 40% of newborns with CDH. Ventricular performance is not only a predictor of disease severity but also mortality and need for ECMO. We studied the utility of serial echocardiography in the management of newborns with CDH and on survival outcomes.Study Design: This is a retrospective study wherein the demographic, clinical and echocardiographic data were retrieved from the local CDH registry and hospital clinical database. We studied the correlation of timed echocardiographic findings with mortality and other outcomes.Results: Fourty-two newborns with CDH were admitted during the study period (M/F:19/23), with median gestation of 38 weeks (IQR:36-39) and birth weight of 2.83 kg (IQR 2.45-3.17). Thirty-one were left-sided, seven right, one central, and three bilateral hernias. Twelve infants (28%) died in early infancy. Three infants were excluded from our analysis due to either palliation at birth or significant cardiac anomaly, resulting in a total of 137 echos from 39 infants being included in the analysis. Seventy percent of newborns who died and had an echo in first 72 hours, suffered from moderate to severe PH. Birth weight <2.8Kg, RVSP> 45.5 in the first 72 hours and postoperative VIS >23.5 and RSS >4.3 were good predictors of mortality in our cohort. Markers of elevated pulmonary pressures and cardiac function were useful in guiding therapy.Conclusions: Serial timed functional echocardiography (f-Echo) monitoring allows targeted therapy of patients with CDH. Birth weight, initial severity of pulmonary hypertension and postop RSS and VIS may be useful in predicting mortality.

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Echocardiographic Assessment of the Transitional Circulation

Ashrafi

Altit

2021

Echocardiography in Pediatric and Congenital Heart Disease

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Left ventricular cardiac output is a reliable predictor of extracorporeal life support in neonates with congenital diaphragmatic hernia

Cited by 20 publications

References 16 publications

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

The Utility of serial Echocardiography parameters in the Management of newborns with Congenital `Diaphragmatic Hernia (CDH) and predictors of Mortality

Echocardiographic Assessment of the Transitional Circulation

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