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The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia

In newborns with congenital diaphragmatic hernia (CDH), the radiographic lung area is correlated with functional residual capacity (FRC) and represents an alternative method to estimate lung hypoplasia. In a cohort of newborn CDH survivors, we retrospectively evaluated the relationship between radio...

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Autores principales: Amodeo, Ilaria, Raffaeli, Genny, Pesenti, Nicola, Macchini, Francesco, Condò, Valentina, Borzani, Irene, Persico, Nicola, Fabietti, Isabella, Ophorst, Marijke, Ghirardello, Stefano, Gangi, Silvana, Colnaghi, Mariarosa, Mosca, Fabio, Cavallaro, Giacomo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661933/
https://www.ncbi.nlm.nih.gov/pubmed/33194913
http://dx.doi.org/10.3389/fped.2020.581809
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author Amodeo, Ilaria
Raffaeli, Genny
Pesenti, Nicola
Macchini, Francesco
Condò, Valentina
Borzani, Irene
Persico, Nicola
Fabietti, Isabella
Ophorst, Marijke
Ghirardello, Stefano
Gangi, Silvana
Colnaghi, Mariarosa
Mosca, Fabio
Cavallaro, Giacomo
author_facet Amodeo, Ilaria
Raffaeli, Genny
Pesenti, Nicola
Macchini, Francesco
Condò, Valentina
Borzani, Irene
Persico, Nicola
Fabietti, Isabella
Ophorst, Marijke
Ghirardello, Stefano
Gangi, Silvana
Colnaghi, Mariarosa
Mosca, Fabio
Cavallaro, Giacomo
author_sort Amodeo, Ilaria
collection PubMed
description In newborns with congenital diaphragmatic hernia (CDH), the radiographic lung area is correlated with functional residual capacity (FRC) and represents an alternative method to estimate lung hypoplasia. In a cohort of newborn CDH survivors, we retrospectively evaluated the relationship between radiographic lung area measured on the 1st day of life and long-term respiratory function. As a secondary analysis, we compared radiographic lung areas and respiratory function between patients undergoing fetal endoscopic tracheal occlusion (FETO) and patients managed expectantly (non-FETO). Total, ipsilateral, and contralateral radiographic areas were obtained by tracing lung perimeter as delineated by the diaphragm and rib cage, excluding mediastinal structures and herniated organs. Tidal volume (V(T)), respiratory rate (RR), and their Z-Scores when compared to the norm were collected from pulmonary function tests (PFTs) performed at 12 ± 6 months of age. Linear regression analyses using the absolute Z-Score values for each parameter were performed. In CDH survivors, an increase in total and ipsilateral lung area measured at birth was related to a reduction in the absolute Z-Score for V(T) in PFTs (p = 0.046 and p = 0.023, respectively), indicating a trend toward an improvement in pulmonary volumes and V(T) normalization. Radiographic lung areas were not significantly different between FETO and non-FETO patients, suggesting a volumetric lung increase due to prenatal intervention. However, the mean Z-Score value for RR was significantly higher in the FETO group (p < 0.001), probably due to impaired diaphragmatic motility in the most severe cases. Further analyses are necessary to better characterize the role of the radiographic pulmonary area in the prognostic evaluation of respiratory function in patients with CDH. Clinical Trial Registration: This trial was registered at ClinicalTrials.gov with the identifier NCT04396028.
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spelling pubmed-76619332020-11-13 The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia Amodeo, Ilaria Raffaeli, Genny Pesenti, Nicola Macchini, Francesco Condò, Valentina Borzani, Irene Persico, Nicola Fabietti, Isabella Ophorst, Marijke Ghirardello, Stefano Gangi, Silvana Colnaghi, Mariarosa Mosca, Fabio Cavallaro, Giacomo Front Pediatr Pediatrics In newborns with congenital diaphragmatic hernia (CDH), the radiographic lung area is correlated with functional residual capacity (FRC) and represents an alternative method to estimate lung hypoplasia. In a cohort of newborn CDH survivors, we retrospectively evaluated the relationship between radiographic lung area measured on the 1st day of life and long-term respiratory function. As a secondary analysis, we compared radiographic lung areas and respiratory function between patients undergoing fetal endoscopic tracheal occlusion (FETO) and patients managed expectantly (non-FETO). Total, ipsilateral, and contralateral radiographic areas were obtained by tracing lung perimeter as delineated by the diaphragm and rib cage, excluding mediastinal structures and herniated organs. Tidal volume (V(T)), respiratory rate (RR), and their Z-Scores when compared to the norm were collected from pulmonary function tests (PFTs) performed at 12 ± 6 months of age. Linear regression analyses using the absolute Z-Score values for each parameter were performed. In CDH survivors, an increase in total and ipsilateral lung area measured at birth was related to a reduction in the absolute Z-Score for V(T) in PFTs (p = 0.046 and p = 0.023, respectively), indicating a trend toward an improvement in pulmonary volumes and V(T) normalization. Radiographic lung areas were not significantly different between FETO and non-FETO patients, suggesting a volumetric lung increase due to prenatal intervention. However, the mean Z-Score value for RR was significantly higher in the FETO group (p < 0.001), probably due to impaired diaphragmatic motility in the most severe cases. Further analyses are necessary to better characterize the role of the radiographic pulmonary area in the prognostic evaluation of respiratory function in patients with CDH. Clinical Trial Registration: This trial was registered at ClinicalTrials.gov with the identifier NCT04396028. Frontiers Media S.A. 2020-10-30 /pmc/articles/PMC7661933/ /pubmed/33194913 http://dx.doi.org/10.3389/fped.2020.581809 Text en Copyright © 2020 Amodeo, Raffaeli, Pesenti, Macchini, Condò, Borzani, Persico, Fabietti, Ophorst, Ghirardello, Gangi, Colnaghi, Mosca and Cavallaro. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Amodeo, Ilaria
Raffaeli, Genny
Pesenti, Nicola
Macchini, Francesco
Condò, Valentina
Borzani, Irene
Persico, Nicola
Fabietti, Isabella
Ophorst, Marijke
Ghirardello, Stefano
Gangi, Silvana
Colnaghi, Mariarosa
Mosca, Fabio
Cavallaro, Giacomo
The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title_full The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title_fullStr The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title_full_unstemmed The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title_short The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia
title_sort neoapache study protocol i: assessment of the radiographic pulmonary area and long-term respiratory function in newborns with congenital diaphragmatic hernia
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661933/
https://www.ncbi.nlm.nih.gov/pubmed/33194913
http://dx.doi.org/10.3389/fped.2020.581809
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