Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia
Background/Purpose: Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension i...
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| Veröffentlicht in: | Journal of pediatric surgery 2003-01, Vol.38 (1), p.17-20 |
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| container_title | Journal of pediatric surgery |
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| creator | Walker, G.M. Kasem, K.F. O'Toole, S.J. Watt, A. Skeoch, C.H. Davis, C.F. |
| description | Background/Purpose: Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. Methods: Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days ± 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. Results: Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 ± 5.3 hours). The volume required to fill the lungs increased significantly (P |
| doi_str_mv | 10.1053/jpsu.2003.50002 |
| format | Article |
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Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. Methods: Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days ± 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. Results: Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 ± 5.3 hours). The volume required to fill the lungs increased significantly (P <.02). The radiographic dimension of the affected lung increased significantly (mean percentage increase, 272%; P <.02). The contralateral lung dimension also increased (mean percentage increase 51%; P <.02). CDH repair was undertaken on ECMO in all cases. All patients survived (follow-up, 3 to 42 months). Conclusions: This protocol of early perfluorodecalin lung distension in infants with severe CDH on ECMO support resulted in significant radiographic lung enlargement. Clinical outcomes are encouraging. Possible mechanisms include alveolar recruitment, alveolar dilatation, and accelerated postnatal lung growth. J Pediatr Surg 38:17-20. Copyright 2003, Elsevier Science (USA). All rights reserved.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1053/jpsu.2003.50002</identifier><identifier>PMID: 12592611</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>congenital diaphragmatic hernia ; extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - methods ; Fluorocarbons - administration & dosage ; Hernia, Diaphragmatic - therapy ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant ; Infant, Newborn ; Intubation, Intratracheal ; Lung - diagnostic imaging ; Lung - growth & development ; Lung Volume Measurements - methods ; Perfluorocarbon ; perfluorodecalin ; Radiography ; Survival Rate ; Treatment Outcome</subject><ispartof>Journal of pediatric surgery, 2003-01, Vol.38 (1), p.17-20</ispartof><rights>2003</rights><rights>Copyright 2003, Elsevier Science (USA). All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-2d92b643436a6a99f05594bae6205ee5e15ee1dbfc2a059127a08628af5dadba3</citedby><cites>FETCH-LOGICAL-c384t-2d92b643436a6a99f05594bae6205ee5e15ee1dbfc2a059127a08628af5dadba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/jpsu.2003.50002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12592611$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walker, G.M.</creatorcontrib><creatorcontrib>Kasem, K.F.</creatorcontrib><creatorcontrib>O'Toole, S.J.</creatorcontrib><creatorcontrib>Watt, A.</creatorcontrib><creatorcontrib>Skeoch, C.H.</creatorcontrib><creatorcontrib>Davis, C.F.</creatorcontrib><title>Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Background/Purpose: Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. Methods: Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days ± 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. Results: Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 ± 5.3 hours). The volume required to fill the lungs increased significantly (P <.02). The radiographic dimension of the affected lung increased significantly (mean percentage increase, 272%; P <.02). The contralateral lung dimension also increased (mean percentage increase 51%; P <.02). CDH repair was undertaken on ECMO in all cases. All patients survived (follow-up, 3 to 42 months). Conclusions: This protocol of early perfluorodecalin lung distension in infants with severe CDH on ECMO support resulted in significant radiographic lung enlargement. Clinical outcomes are encouraging. Possible mechanisms include alveolar recruitment, alveolar dilatation, and accelerated postnatal lung growth. J Pediatr Surg 38:17-20. Copyright 2003, Elsevier Science (USA). All rights reserved.</description><subject>congenital diaphragmatic hernia</subject><subject>extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Fluorocarbons - administration & dosage</subject><subject>Hernia, Diaphragmatic - therapy</subject><subject>Hernias, Diaphragmatic, Congenital</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intubation, Intratracheal</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - growth & development</subject><subject>Lung Volume Measurements - methods</subject><subject>Perfluorocarbon</subject><subject>perfluorodecalin</subject><subject>Radiography</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1Lw0AQhhdRbK2evUlO3tLuRzZtjlLqBxS8qNdlsjtpt6SbuJso_fdubMGTMMzA8MwL8xByy-iUUSlmuzb0U06pmEpKKT8jYyYFSyUV83MyjhueiixfjMhVCLtIiDlll2TEuCx4ztiYfKzA14ekRV_VfeMbgxpq65K6d5vE2NChC7ZxiR2qAteF5Nt220Q3boPOdlBHCtqth80eOquTLXpn4ZpcVFAHvDnNCXl_XL0tn9P169PL8mGdarHIupSbgpd5JjKRQw5FUVEpi6wEzDmViBJZ7MyUleZAZcH4HOgi5wuopAFTgpiQ-2Nu65vPHkOn9jZorGtw2PRBzQUVUUYRwdkR1L4JwWOlWm_34A-KUTWoVINKNahUvyrjxd0pui_3aP74k7sIFEcA44NfFr0K2qLTaKxH3SnT2H_DfwAZxYTF</recordid><startdate>200301</startdate><enddate>200301</enddate><creator>Walker, G.M.</creator><creator>Kasem, K.F.</creator><creator>O'Toole, S.J.</creator><creator>Watt, A.</creator><creator>Skeoch, C.H.</creator><creator>Davis, C.F.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200301</creationdate><title>Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia</title><author>Walker, G.M. ; Kasem, K.F. ; O'Toole, S.J. ; Watt, A. ; Skeoch, C.H. ; Davis, C.F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-2d92b643436a6a99f05594bae6205ee5e15ee1dbfc2a059127a08628af5dadba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>congenital diaphragmatic hernia</topic><topic>extracorporeal membrane oxygenation</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Fluorocarbons - administration & dosage</topic><topic>Hernia, Diaphragmatic - therapy</topic><topic>Hernias, Diaphragmatic, Congenital</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intubation, Intratracheal</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - growth & development</topic><topic>Lung Volume Measurements - methods</topic><topic>Perfluorocarbon</topic><topic>perfluorodecalin</topic><topic>Radiography</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walker, G.M.</creatorcontrib><creatorcontrib>Kasem, K.F.</creatorcontrib><creatorcontrib>O'Toole, S.J.</creatorcontrib><creatorcontrib>Watt, A.</creatorcontrib><creatorcontrib>Skeoch, C.H.</creatorcontrib><creatorcontrib>Davis, C.F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walker, G.M.</au><au>Kasem, K.F.</au><au>O'Toole, S.J.</au><au>Watt, A.</au><au>Skeoch, C.H.</au><au>Davis, C.F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2003-01</date><risdate>2003</risdate><volume>38</volume><issue>1</issue><spage>17</spage><epage>20</epage><pages>17-20</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>Background/Purpose: Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. Methods: Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days ± 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. Results: Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 ± 5.3 hours). The volume required to fill the lungs increased significantly (P <.02). The radiographic dimension of the affected lung increased significantly (mean percentage increase, 272%; P <.02). The contralateral lung dimension also increased (mean percentage increase 51%; P <.02). CDH repair was undertaken on ECMO in all cases. All patients survived (follow-up, 3 to 42 months). Conclusions: This protocol of early perfluorodecalin lung distension in infants with severe CDH on ECMO support resulted in significant radiographic lung enlargement. Clinical outcomes are encouraging. Possible mechanisms include alveolar recruitment, alveolar dilatation, and accelerated postnatal lung growth. J Pediatr Surg 38:17-20. Copyright 2003, Elsevier Science (USA). All rights reserved.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>12592611</pmid><doi>10.1053/jpsu.2003.50002</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | congenital diaphragmatic hernia extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - methods Fluorocarbons - administration & dosage Hernia, Diaphragmatic - therapy Hernias, Diaphragmatic, Congenital Humans Infant Infant, Newborn Intubation, Intratracheal Lung - diagnostic imaging Lung - growth & development Lung Volume Measurements - methods Perfluorocarbon perfluorodecalin Radiography Survival Rate Treatment Outcome |
| title | Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia |
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