Lung to head ratio in infants with congenital diaphragmatic hernia does not predict long term pulmonary hypertension

Garcia, Alejandro V.; Fingeret, Abbey L.; Thirumoorthi, Arul; Hahn, E. L.; Leskowitz, Matthew J.; Aspelund, Gudrun; Krishnan, Usha; Stolar, Charles J.H.

doi:10.1016/j.jpedsurg.2012.10.031

Cited by 26 publications

(27 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We did not find any significant difference in the duration of inotropic support between the two groups, suggesting the severity of pulmonary hypertension did not differ between FETO and non-FETO infants. In one study [10], the prenatal LHR predicted pulmonary hypertension at 1 month, but not in the longer term, and the authors suggested their results indicated remodelling of the pulmonary vasculature over time. None of the infants included in that study had undergone FETO, and our results demonstrate in such patients and in those who had not undergone FETO, it is the LHR at referral prior to delivery which differs significantly according to death or survival.…”

Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic hernia—influence of fetoscopic tracheal occlusion on outcomes and predictors of survival

et al. 2016

View full text Add to dashboard Cite

• Randomised controlled trials have demonstrated that foetal endotracheal occlusion (FETO) in high risk infants with congenital diaphragmatic hernia is associated with a higher survival rate. • Mortality is greater in foetuses who underwent FETO and delivered prior to 35 weeks of gestation. What is New: • Infants who had undergone FETO compared to those who had not had significantly longer durations of mechanical ventilation, supplementary oxygen and hospital stay. • Regardless of antenatal intervention, the lowest oxygenation index in the first 24 h was the best predictor of survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic hernia—influence of fetoscopic tracheal occlusion on outcomes and predictors of survival

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Akciğer baş oranı (Lungto-head ratio:LHR) ile ölçülür: Ultrasonografik ölçümde LHR 1'in altında ise kötü prognozu gös-terir (15) .…”

Section: Prognostik Faktörlerunclassified

“…• Fötal akciğer hacim ölçümü: Fötal MR ile akciğer hacim ölçümünde rölatif akciğer hacminin %40'ın altında olması kötü prognozu gösterir (15) . (16)(17) .…”

Section: Prognostik Faktörlerunclassified

See 1 more Smart Citation

Endoscopic approach to diaphragmatic pathologies

Doğruyol¹

2016

Tccd

View full text Add to dashboard Cite

show abstract

“…Low LHR and high CVR have been shown to predict mortality and other adverse pulmonary consequences [5]. Survival rates in severe CDH (LHR <1.0 and liver herniation into the thorax) have been reported to be <50% [4,6], reflecting lung hypoplasia, complicated by neonatal pulmonary hypertension (PH) [7,8]. In contrast, even in the most severely affected fetuses with CPAM, mortality is extremely low [5].…”

Section: Introductionmentioning

confidence: 99%

Mass Effect Alone May Not Explain Pulmonary Vascular Pathology in Severe Congenital Diaphragmatic Hernia

Derderian

Jayme²,

Cheng³

et al. 2015

Fetal Diagn Ther

View full text Add to dashboard Cite

Congenital diaphragmatic hernia (CDH) and congenital pulmonary airway malformation (CPAM) are diseases in which chest-occupying lesions can result in severe pulmonary hypoplasia. However, significant postnatal mortality due to pulmonary hypertension (PH) is more often seen in patients with CDH. We analyzed prenatal echocardiographic parameters of pulmonary vascular pathology in these groups to understand whether PH in patients with CDH is secondary to a mass effect or to underlying disease. We analyzed pre- and postnatal characteristics of 26 patients with severe CDH and 23 patients with severe CPAM from 2009 to 2012. Severe mediastinal compression, indicated by a low cardiothoracic ratio, was evident in both groups. However, fetuses with severe CDH had smaller pulmonary arteries bilaterally and higher pulsatility indices in the ipsilateral lung than those with severe CPAM. Prenatal modified McGoon indices were significantly lower in patients with CDH versus CPAM. Consistent with these prenatal measurements, postnatal PH was seen more frequently in patients with CDH compared to CPAM. Patients with severe CDH have prenatal evidence of pulmonary vascular remodeling compared to patients with severe CPAM. These results suggest a multifactorial origin for PH in CDH and support the idea of using prenatal medical therapies to promote vascular remodeling in these patients.

show abstract

Lung to head ratio in infants with congenital diaphragmatic hernia does not predict long term pulmonary hypertension

Cited by 26 publications

References 15 publications

Congenital diaphragmatic hernia—influence of fetoscopic tracheal occlusion on outcomes and predictors of survival

Congenital diaphragmatic hernia—influence of fetoscopic tracheal occlusion on outcomes and predictors of survival

Endoscopic approach to diaphragmatic pathologies

Mass Effect Alone May Not Explain Pulmonary Vascular Pathology in Severe Congenital Diaphragmatic Hernia

Contact Info

Product

Resources

About