Intact cord resuscitation in newborns with ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Intact cord resuscitation in newborns with congenital diaphragmatic hernia: insights from a lamb model.
Auteur(s) :
Teillet, Baptiste [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Manœuvrier, F. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rougraff, Celine [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Besengez, Capucine [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Bernard, L. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Wojtanowski, A. [Auteur]
Ghesquieres, L. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Storme, Laurent [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Mur, S. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Sharma, Dyuti [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Le Duc, Kevin [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Manœuvrier, F. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rougraff, Celine [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Besengez, Capucine [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Bernard, L. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Wojtanowski, A. [Auteur]
Ghesquieres, L. [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Storme, Laurent [Auteur]
![refId](/themes/Mirage2//images/idref.png)
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Mur, S. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Sharma, Dyuti [Auteur]
![refId](/themes/Mirage2//images/idref.png)
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Le Duc, Kevin [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Titre de la revue :
Frontiers in Pediatrics
Nom court de la revue :
Front Pediatr
Numéro :
11
Pagination :
1236556
Éditeur :
Frontiers
Date de publication :
2023-09-06
ISSN :
2296-2360
Mot(s)-clé(s) en anglais :
pulmonary hypoplasia
congenital diaphragmatic hernia (CDH)
lamb model
pulmonary hypertension
respiratory-mechanics
congenital diaphragmatic hernia (CDH)
lamb model
pulmonary hypertension
respiratory-mechanics
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Introduction: Congenital diaphragmatic hernia (CDH) is a rare condition characterized by pulmonary hypoplasia, vascular dystrophy, and pulmonary hypertension at birth. Validation of the lamb model as an accurate representation ...
Lire la suite >Introduction: Congenital diaphragmatic hernia (CDH) is a rare condition characterized by pulmonary hypoplasia, vascular dystrophy, and pulmonary hypertension at birth. Validation of the lamb model as an accurate representation of human CDH is essential to translating research findings into clinical practice and understanding disease mechanisms. This article emphasizes the importance of validating the lamb model to study CDH pathogenesis and develop innovative therapeutics. Material and methods: At 78 days of gestation, the fetal lamb's left forelimb was exposed through a midline laparotomy and hysterotomy, and a supra diaphragmatic thoracotomy was performed to allow the digestive organs to ascend into the thoracic cavity. At 138 ± 3 days of gestation, lambs were delivered via a cesarean section; then, with umbilical cord intact during 1 hour, the lambs were mechanically ventilated with gentle ventilation in a pressure-controlled mode for 2 h. Results: CDH lambs exhibited a lower left lung-to-body weight ratio of 5.3 (2.03), p < 0.05, and right lung-to-body weight ratio of 8.2 (3.1), p < 0.05. They reached lower Vt/kg (tidal volume per kg) during the course of the resuscitation period with 1.2 (0.7) ml/kg at 10 min and 3 (1.65) ml/kg at 60 min (p < 0.05). Compliance of the respiratory system was lower in CDH lambs with 0.5 (0.3) ml/cmH2O at 60 min (p < 0.05) and 0.9 (0.26) ml/cmH2O at 120 min (p < 0.05). Differences between pre- and postductal SpO2 were higher with 15.1% (21.4%) at 20 min and 6.7% (14.5%) at 80 min (p < 0.05). CDH lambs had lower differences between inspired and expired oxygen fractions with 4.55% (6.84%) at 20 min and 6.72% (8.57%) at 60 min (p < 0.05). CDH lamb had lower left ventricle [2.73 (0.5) g/kg, p < 0.05] and lower right ventricle [0.69 (0.8), p < 0.05] to left ventricle ratio. Discussion: CDH lambs had significantly lower tidal volume than control lambs due to lower compliance of the respiratory system and higher airway resistance. These respiratory changes are characteristic of CDH infants and are associated with higher mortality rates. CDH lambs also exhibited pulmonary hypertension, pulmonary hypoplasia, and left ventricle hypoplasia, consistent with observations in human newborns. To conclude, our lamb model successfully provides a reliable representation of CDH and can be used to study its pathophysiology and potential interventions.Lire moins >
Lire la suite >Introduction: Congenital diaphragmatic hernia (CDH) is a rare condition characterized by pulmonary hypoplasia, vascular dystrophy, and pulmonary hypertension at birth. Validation of the lamb model as an accurate representation of human CDH is essential to translating research findings into clinical practice and understanding disease mechanisms. This article emphasizes the importance of validating the lamb model to study CDH pathogenesis and develop innovative therapeutics. Material and methods: At 78 days of gestation, the fetal lamb's left forelimb was exposed through a midline laparotomy and hysterotomy, and a supra diaphragmatic thoracotomy was performed to allow the digestive organs to ascend into the thoracic cavity. At 138 ± 3 days of gestation, lambs were delivered via a cesarean section; then, with umbilical cord intact during 1 hour, the lambs were mechanically ventilated with gentle ventilation in a pressure-controlled mode for 2 h. Results: CDH lambs exhibited a lower left lung-to-body weight ratio of 5.3 (2.03), p < 0.05, and right lung-to-body weight ratio of 8.2 (3.1), p < 0.05. They reached lower Vt/kg (tidal volume per kg) during the course of the resuscitation period with 1.2 (0.7) ml/kg at 10 min and 3 (1.65) ml/kg at 60 min (p < 0.05). Compliance of the respiratory system was lower in CDH lambs with 0.5 (0.3) ml/cmH2O at 60 min (p < 0.05) and 0.9 (0.26) ml/cmH2O at 120 min (p < 0.05). Differences between pre- and postductal SpO2 were higher with 15.1% (21.4%) at 20 min and 6.7% (14.5%) at 80 min (p < 0.05). CDH lambs had lower differences between inspired and expired oxygen fractions with 4.55% (6.84%) at 20 min and 6.72% (8.57%) at 60 min (p < 0.05). CDH lamb had lower left ventricle [2.73 (0.5) g/kg, p < 0.05] and lower right ventricle [0.69 (0.8), p < 0.05] to left ventricle ratio. Discussion: CDH lambs had significantly lower tidal volume than control lambs due to lower compliance of the respiratory system and higher airway resistance. These respiratory changes are characteristic of CDH infants and are associated with higher mortality rates. CDH lambs also exhibited pulmonary hypertension, pulmonary hypoplasia, and left ventricle hypoplasia, consistent with observations in human newborns. To conclude, our lamb model successfully provides a reliable representation of CDH and can be used to study its pathophysiology and potential interventions.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CHU Lille
CHU Lille
Date de dépôt :
2024-05-18T21:04:34Z
2024-05-29T08:38:12Z
2024-05-29T08:38:12Z
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