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Diaphragmatic hernia neonate

Jessica H Rankin, Marsha Elkhunovich, Dina Seif, Mikaela Chilstrom
Neonatal respiratory distress is an emergent condition with a wide differential diagnosis. A 12-day-old newborn presented to the emergency department in respiratory distress. Point-of-care ultrasound allowed clinicians to rapidly exclude cardiac disease and pneumothorax as possible causes of the patient's respiratory distress, and expedited the identification of congenital diaphragmatic hernia. The ultrasound findings and technique, epidemiology, pathophysiology, and radiological diagnosis of congenital diaphragmatic hernia are reviewed...
October 2016: Pediatric Emergency Care
Wan-Ting Hung, Shu-Chien Huang, Dania El Mazloum, Wen-Hsi Lin, Hui-Hsin Yang, Hung-Chieh Chou, En-Ting Wu, Chien-Yi Chen, Po-Nien Tsao, Wu-Shiun Hsieh, Wen-Ming Hsu, Yih-Sharng Chen, Hong-Shiee Lai
BACKGROUND/PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a treatment option for stabilizing neonates with congenital diaphragmatic hernia (CDH) in a critical condition when standard therapy fails. However, the use of this approach in Taiwan has not been previously reported. METHODS: The charts of all neonates with CDH treated in our institute during the period 2007-2014 were reviewed. After 2010, patients who could not be stabilized with conventional treatment were candidates for ECMO...
October 7, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Catherine Fox, Michael Stewart, Sebastian K King, Neil Patel
BACKGROUND: Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. METHODS: A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012)...
September 15, 2016: Journal of Pediatric Surgery
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Maria Esther J R Ceccon, Renata A Vieira, Werther Brunow de Carvalho
No abstract text is available yet for this article.
October 2016: Pediatric Critical Care Medicine
J Zimmer, T Takahashi, A D Hofmann, Prem Puri
PURPOSE: High mortality and morbidity in infants born with congenital diaphragmatic hernia (CDH) are attributed to pulmonary hypoplasia and pulmonary hypertension (PH). Forkhead box (Fox) transcription factors are known to be crucial for cell proliferation and homeostasis. FoxF1 is essential for lung morphogenesis, vascular development, and endothelial proliferation. Mutations in FoxF1 and also the Fox family member FoxC2 have been identified in neonates with PH. In human and experimental models of arterial PH, the Fox protein FoxO1 was found to be downregulated...
September 23, 2016: Pediatric Surgery International
Badri Prasad Das, Anil Prasad Singh, Ram Badan Singh
INTRODUCTION: Underdevelopment of the lung parenchyma associated with abnormal growth of pulmonary vasculature in neonates with congenital diaphragmatic hernia results in pulmonary hypertension which mandates smooth elective mechanical ventilation in postoperative period, for proper alveolar recruitment and oxygenation, allowing lungs to mature enough for its functional anatomy and physiology. Dexmedetomidine is sympatholytic, reduces pulmonary vascular resistance and exerts sedative and analgesic property to achieve stable hemodynamics during elective ventilation...
June 2016: Anesthesiology and Pain Medicine
Carmen Mesas Burgos, Agnes Modée, Elin Öst, Björn Frenckner
INTRODUCTION: Despite improvements of neonatal intensive care, mortality among patients born with congenital diaphragmatic hernia (CDH), remains high, and there is a significant late mortality in this cohort. OBJECTIVE: The aim of this study was to evaluate the causes of death among 251 consecutive CDH patients treated at our institution during the last 26years period. METHODS: Retrospective review of all causes of death between 1990 and 2015 of the CDH cohort prospectively collected in a database...
September 5, 2016: Journal of Pediatric Surgery
Katrina L Weaver, Joanne E Baerg, Manabu Okawada, Go Miyano, Katherine A Barsness, Martin Lacher, Dani O Gonzalez, Peter C Minneci, Lena Perger, Shawn D St Peter
INTRODUCTION: Thoracoscopic repair of a congenital diaphragmatic hernia (CDH) in the neonate is controversial due to reports of increased hernia recurrence. A multicenter review on thoracoscopic CDH repair was conducted to evaluate outcomes and to identify factors that are associated with recurrence. METHODS: A multicenter retrospective review was conducted from 2009 to 2015 in neonates who were treated for CDH with thoracoscopic repair. Demographics, preoperative, intraoperative, including repair techniques, and postoperative variables were analyzed by using descriptive statistics...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Satoshi Umeda, Shigeru Miyagawa, Satsuki Fukushima, Noriko Oda, Atsuhiro Saito, Yoshiki Sakai, Yoshiki Sawa, Hiroomi Okuyama
Lung hypoplasia and pulmonary hypertension are the major causes of mortality in neonates with congenital diaphragmatic hernia (CDH). Although the prostaglandin pathway plays a pivotal role in lung development, the reported efficacy of postnatal prostaglandin agonist treatment is suboptimal. We hypothesized that prenatal treatment with ONO-1301SR, a slow-release form of a novel synthetic prostacyclin agonist with thromboxane inhibitory activity, might enhance the development of lungs exhibiting hypoplasia in the fetal period...
2016: PloS One
Edward Araujo Júnior, Gabriele Tonni, Wellington P Martins, Rodrigo Ruano
Introduction This study aims to assess the procedure-related complications and survival following fetoscopic endotracheal occlusion (FETO) for severe congenital diaphragmatic hernia. Materials and Methods A systematic review and meta-analysis of PubMed and Scopus database searching for FETO procedure in severe CDH (lung-to-head ratio [LHR] < 1.0 and/or observed/expected LHR < 0.26 and > 1/3 liver herniation) were performed. The relative risk was assessed and 95% confidence interval (CI) calculated...
August 14, 2016: European Journal of Pediatric Surgery
Nicola Persico, Isabella Fabietti, Fabrizio Ciralli, Valerio Gentilino, Francesco D'Ambrosi, Simona Boito, Manuela Wally Ossola, Mariarosa Colnaghi, Valentina Condò, Francesco Macchini, Ernesto Leva, Fabio Mosca, Luigi Fedele
OBJECTIVE: To report on our experience in the prenatal treatment of severe congenital diaphragmatic hernia (CDH) by fetoscopic endoluminal tracheal occlusion (FETO). METHODS: Between 2012 and 2014, FETO was performed at our center in 21 cases of CDH considered to be severe based on sonographic measurement of observed/expected lung-to-head ratio (O/E LHR) and side of the defect. We reported pre- and postoperative ultrasound findings, procedure-related complications, pregnancy outcome and survival at 1-3 years of age...
August 4, 2016: Fetal Diagnosis and Therapy
Ruža Grizelj, Katarina Bojanić, Ena Pritišanac, Tomislav Luetić, Jurica Vuković, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: The extent of lung hypoplasia in neonates with congenital diaphragmatic hernia (CDH) can be assessed from gas exchange. We examined the role of preductal capillary blood gases in prognosticating outcome in patients with CDH. METHODS: We retrospectively reviewed demographic data, disease characteristics, and preductal capillary blood gases on admission and within 24 h following admission for 44 high-risk outborn neonates. All neonates were intubated after delivery due to acute respiratory distress, and were emergently transferred via ground ambulance to our unit between 1/2000 and 12/2014...
July 29, 2016: BMC Pediatrics
Mario A Riquelme, Carlos D Guajardo, Marco A Juarez-Parra, Rodolfo A Elizondo, Julio C Cortinas
[This corrects the article on p. 31 in vol. 4, PMID: 26290813.].
July 2016: Journal of Neonatal Surgery
Nao Kawamura, Samarjeet Bhandal
Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. It is helpful to be familiar with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion, as imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of other associated lesions can be determined, facilitating appropriate management to prevent the potential complications...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Carmen Mesas Burgos, Erik G Pearson, Marcus Davey, John Riley, Huimin Jia, Pablo Laje, Alan W Flake, William H Peranteau
BACKGROUND: Pulmonary hypoplasia and hypertension is a leading cause of morbidity and mortality in congenital diaphragmatic hernia (CDH). The etiologic insult occurs early in gestation highlighting the potential of prenatal interventions. We evaluated prenatal pharmacologic therapies in the nitrofen CDH model. METHODS: Olive oil or nitrofen were administered alone or with dexamethasone (DM), sildenafil, or DM+sildenafil to pregnant rats. Newborn pups were assessed for lung function, structure and pulmonary artery (PA) flow and resistance...
October 2016: Pediatric Research
Sastha Ahanatha Pillai, Santhanakrishnan Chinnappan
Patients with congenital diaphragmatic hernias (CDH) usually present in the neonatal period with respiratory distress. Delayed presentation of CDH in adults is rare and difficult to diagnose. We present a 42-year-old female patient who came with complaints of epigastric pain and breathlessness on exertion. X-ray and CT scan of the chest revealed a right-sided Morgagni hernia. The contents of the hernia were reduced and a primary tension free repair of the hernia defect was done through laparotomy. The postoperative course was uneventful...
June 2016: Indian Journal of Surgery
Colin D Gause, Grace Hsiung, Ben Schwab, Matthew Clifton, Carroll M Harmon, Katherine A Barsness
BACKGROUND: Mandates for improved patient safety and increasing work hour restrictions have resulted in changes in surgical education. Educational courses increasingly must meet those needs. We sought to determine the experience, skill level, and the impact of simulation-based education (SBE) on two cohorts of pediatric surgery trainees. MATERIALS AND METHODS: After Institutional Review Board (IRB) exempt determination, a retrospective review was performed of evaluations for an annual advanced minimally invasive surgery (MIS) course over 2 consecutive years...
August 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Michael Collin, Sarah Trinder, Corrado Minutillo, Shripada Rao, Jan Dickinson, Naeem Samnakay
BACKGROUND/PURPOSE: This study aims to retrospectively review outcomes, including neurodevelopmental outcomes, of neonatal right sided congenital diaphragmatic hernias (RCDH) compared with left sided congenital diaphragmatic hernias (L-CDH) treated surgically at our institute. METHODS: A retrospective review was undertaken of all cases of congenital diaphragmatic hernia (CDH) treated at Princess Margaret Hospital for Children (PMH), Perth, born between 1st January 2002 and 1st August 2012...
September 2016: Journal of Pediatric Surgery
Elizabeth Maughan, Flore Lesage, Colin R Butler, Robert E Hynds, Richard Hewitt, Sam M Janes, Jan A Deprest, Paolo De Coppi
Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach...
June 2016: Seminars in Pediatric Surgery
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