کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4155435 1273746 2015 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Safety and efficacy of perflubron-induced lung growth in neonates with congenital diaphragmatic hernia: Results of a prospective randomized trial
ترجمه فارسی عنوان
ایمنی و اثربخشی رشد ریه ناشی از پرفولبرون در نوزادان مبتلا به فتق دیافراگم مادرزادی: نتایج یک آزمایش تصادفی آیندهنگر
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

BackgroundMechanical transduction has been shown to promote fetal lung growth. We examined the safety and efficacy of perflubron-induced lung growth (PILG) in neonates with congenital diaphragmatic hernia (CDH) requiring extracorporeal membrane oxygenation (ECMO).MethodsInfants with left-sided CDH requiring ECMO were eligible. Exclusion criteria included active air leak, intracranial hemorrhage, major congenital anomalies, and oxygenation index > 25 for 24 hours. Perflubron was instilled endotracheally and continuous positive airway pressure was applied without ventilation. Survival to discharge was the primary outcome. Daily chest radiographs were used to quantify lung size (the secondary outcome). Midway through the study our institutional practice shifted toward earlier repair of CDH.ResultsEight infants were randomized to each arm. In the conventional-ventilation arm, six survived to discharge (75%). In the perflubron arm, four survived (50%); the others succumbed to suprasystemic pulmonary hypertension. No adverse events related to perflubron occurred. Within the perflubron group, 4/8 patients had “late repair” (15–19 days of life [DOL]) and 4 had “early repair” (2–3 DOL). “Early repair” patients had similar total lung growth, but accelerated growth and shorter ECMO runs.ConclusionPILG is safe in CDH and doubles the total lung size on average (accelerated with early repair). Despite amelioration of pulmonary hypoplasia with PILG, pulmonary hypertension persists.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 50, Issue 7, July 2015, Pages 1083–1087
نویسندگان
, , , , , ,