Document Detail


Late gestation fetal magnetic resonance imaging-derived total lung volume predicts postnatal survival and need for extracorporeal membrane oxygenation support in isolated congenital diaphragmatic hernia.
MedLine Citation:
PMID:  21683216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Magnetic resonance imaging (MRI) has been used as an imaging modality to assess pulmonary hypoplasia in congenital diaphragmatic hernias (CDHs). The objective of this study was to determine if there is a correlation between late gestational fetal MRI-derived total lung volumes (TLVs) and CDH outcomes.
METHODS: From 2006 to 2009, 44 patients met criteria of an isolated CDH with a late gestational MRI evaluation. The prenatal TLV (in milliliters) was obtained between 32 and 34 weeks gestation. The measured study outcomes included survival, need for extracorporeal membrane oxygenation (ECMO), and length of stay.
RESULTS: There were 39 left and 5 right CDH patients. The average TLV was significantly lower for nonsurvivors (P = .01), and there was a significant association between lower TLV and the need for ECMO (P = .0001). When stratified by TLV, patients with a TLV of greater than 40 mL had a 90% survival vs 35% survival for a TLV of less than 20 mL. Furthermore, patients with a TLV greater than 40 mL had a lower rate of ECMO use (10%) than patients with a TLV of less than 20 mL (86%). Shorter length of stay was found to correlate with increasing TLV (P = .022).
CONCLUSION: Late gestation fetal MRI-derived TLV significantly correlates with postnatal survival and need for ECMO. Fetal MRI may be useful for the evaluation of patients who present late in gestation with a CDH.
Authors:
Timothy C Lee; Foong Y Lim; Sundeep G Keswani; Jason S Frischer; Beth Haberman; Paul S Kingma; Mounira Habli; Ronald K Jaekle; Gina Sharp; Beth Kline-Fath; Eva I Rubio; Maria Calvo; Carolina Guimaraes; Timothy M Crombleholme
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  46     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-20     Completed Date:  2011-10-31     Revised Date:  2014-01-10    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1165-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Extracorporeal Membrane Oxygenation / methods*
Female
Fetal Diseases / diagnosis
Gestational Age
Hernia, Diaphragmatic / congenital*,  diagnosis,  mortality,  therapy
Humans
Infant, Newborn
Lung Volume Measurements
Magnetic Resonance Imaging / methods*
Postnatal Care / methods
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Prenatal Diagnosis / methods*
Prognosis
Retrospective Studies
Survival Analysis
Tidal Volume
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K08 HL089505/HL/NHLBI NIH HHS; UL1 TR000077/TR/NCATS NIH HHS
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