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Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia

Congenital diaphragmatic hernia (CDH) is associated with pulmonary hypoplasia and respiratory morbidity. To assess whether respiratory morbidity during the first 2 years of life in infants with left-sided CDH is associated with fetal lung volume (FLV) evaluated by the observed-to-expected FLV ratio...

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Autores principales: Cerbelle, Valentine, Le Duc, Kévin, Lejeune, Stephanie, Mur, Sébastien, Lerisson, Héloise, Drumez, Elodie, Sfeir, Rony, Bigot, Julien, Verpillat, Pauline, Boukhris, Riadh, Vaast, Pascal, Mordacq, Clémence, Thumerelle, Caroline, Storme, Laurent, Deschildre, Antoine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961622/
https://www.ncbi.nlm.nih.gov/pubmed/36836043
http://dx.doi.org/10.3390/jcm12041508
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author Cerbelle, Valentine
Le Duc, Kévin
Lejeune, Stephanie
Mur, Sébastien
Lerisson, Héloise
Drumez, Elodie
Sfeir, Rony
Bigot, Julien
Verpillat, Pauline
Boukhris, Riadh
Vaast, Pascal
Mordacq, Clémence
Thumerelle, Caroline
Storme, Laurent
Deschildre, Antoine
author_facet Cerbelle, Valentine
Le Duc, Kévin
Lejeune, Stephanie
Mur, Sébastien
Lerisson, Héloise
Drumez, Elodie
Sfeir, Rony
Bigot, Julien
Verpillat, Pauline
Boukhris, Riadh
Vaast, Pascal
Mordacq, Clémence
Thumerelle, Caroline
Storme, Laurent
Deschildre, Antoine
author_sort Cerbelle, Valentine
collection PubMed
description Congenital diaphragmatic hernia (CDH) is associated with pulmonary hypoplasia and respiratory morbidity. To assess whether respiratory morbidity during the first 2 years of life in infants with left-sided CDH is associated with fetal lung volume (FLV) evaluated by the observed-to-expected FLV ratio (o/e FLV) on antenatal magnetic resonance imaging (MRI). In this retrospective study, o/e FLV measures were collected. Respiratory morbidity in the first 2 years of life was studied according to two endpoints: treatment with inhaled corticosteroids for >3 consecutive months and hospitalization for any acute respiratory disease. The primary outcome was a favorable progression defined by the absence of either endpoint. Forty-seven patients were included. The median o/e FLV was 39% (interquartile range, 33–49). Sixteen (34%) infants were treated with inhaled corticosteroids and 13 (28%) were hospitalized. The most efficient threshold for a favorable outcome was an o/e FLV ≥ 44% with a sensitivity of 57%, specificity of 79%, negative predictive value of 56%, and positive predictive value of 80%. An o/e FLV ≥ 44% was associated with a favorable outcome in 80% of cases. These data suggest that lung volume measurement on fetal MRI may help to identify children at lower respiratory risk and improve information during pregnancy, patient characterization, decisions about treatment strategy and research, and personalized follow-up.
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spelling pubmed-99616222023-02-26 Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia Cerbelle, Valentine Le Duc, Kévin Lejeune, Stephanie Mur, Sébastien Lerisson, Héloise Drumez, Elodie Sfeir, Rony Bigot, Julien Verpillat, Pauline Boukhris, Riadh Vaast, Pascal Mordacq, Clémence Thumerelle, Caroline Storme, Laurent Deschildre, Antoine J Clin Med Article Congenital diaphragmatic hernia (CDH) is associated with pulmonary hypoplasia and respiratory morbidity. To assess whether respiratory morbidity during the first 2 years of life in infants with left-sided CDH is associated with fetal lung volume (FLV) evaluated by the observed-to-expected FLV ratio (o/e FLV) on antenatal magnetic resonance imaging (MRI). In this retrospective study, o/e FLV measures were collected. Respiratory morbidity in the first 2 years of life was studied according to two endpoints: treatment with inhaled corticosteroids for >3 consecutive months and hospitalization for any acute respiratory disease. The primary outcome was a favorable progression defined by the absence of either endpoint. Forty-seven patients were included. The median o/e FLV was 39% (interquartile range, 33–49). Sixteen (34%) infants were treated with inhaled corticosteroids and 13 (28%) were hospitalized. The most efficient threshold for a favorable outcome was an o/e FLV ≥ 44% with a sensitivity of 57%, specificity of 79%, negative predictive value of 56%, and positive predictive value of 80%. An o/e FLV ≥ 44% was associated with a favorable outcome in 80% of cases. These data suggest that lung volume measurement on fetal MRI may help to identify children at lower respiratory risk and improve information during pregnancy, patient characterization, decisions about treatment strategy and research, and personalized follow-up. MDPI 2023-02-14 /pmc/articles/PMC9961622/ /pubmed/36836043 http://dx.doi.org/10.3390/jcm12041508 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cerbelle, Valentine
Le Duc, Kévin
Lejeune, Stephanie
Mur, Sébastien
Lerisson, Héloise
Drumez, Elodie
Sfeir, Rony
Bigot, Julien
Verpillat, Pauline
Boukhris, Riadh
Vaast, Pascal
Mordacq, Clémence
Thumerelle, Caroline
Storme, Laurent
Deschildre, Antoine
Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title_full Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title_fullStr Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title_full_unstemmed Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title_short Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia
title_sort fetal lung volume appears to predict respiratory morbidity in congenital diaphragmatic hernia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961622/
https://www.ncbi.nlm.nih.gov/pubmed/36836043
http://dx.doi.org/10.3390/jcm12041508
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