Melissa A Schopper1, Laura L Walkup2, Jean A Tkach3, Nara S Higano4, Foong Yen Lim5, Beth Haberman1, Jason C Woods4, Paul S Kingma6. 1. Section of Neonatology, Perinatal and Pulmonary Biology, The Perinatal Institute, Cincinnati, OH. 2. Division of Pulmonary Medicine, Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati, OH. 3. Department of Radiology, Imaging Research Center, Austin, TX. 4. Division of Pulmonary Medicine, Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati, OH; Deparment of Physics, Washington University in St. Louis, St. Louis, MO. 5. Cincinnati Fetal Center, Cincinnati, OH; Divisions of Pediatric General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 6. Section of Neonatology, Perinatal and Pulmonary Biology, The Perinatal Institute, Cincinnati, OH; Cincinnati Fetal Center, Cincinnati, OH. Electronic address: paul.kingma@cchmc.org.
Abstract
OBJECTIVE: To evaluate postnatal lung volume in infants with congenital diaphragmatic hernia (CDH) and determine if a compensatory increase in lung volume occurs during the postnatal period. STUDY DESIGN: Using a novel pulmonary magnetic resonance imaging method for imaging neonatal lungs, the postnatal lung volumes in infants with CDH were determined and compared with prenatal lung volumes obtained via late gestation magnetic resonance imaging. RESULTS: Infants with left-sided CDH (2 mild, 9 moderate, and 1 severe) were evaluated. The total lung volume increased in all infants, with the contralateral lung increasing faster than the ipsilateral lung (mean ± SD: 4.9 ± 3.0 mL/week vs 3.4 ± 2.1 mL/week, P = .005). In contrast to prenatal studies, the volume of lungs of infants with more severe CDH grew faster than the lungs of infants with more mild CDH (Spearman's ρ=-0.086, P = .01). Although the contralateral lung volume grew faster in both mild and moderate groups, the majority of total lung volume growth in moderate CDH came from increased volume of the ipsilateral lung (42% of total lung volume increase in the moderate group vs 32% of total lung volume increase in the mild group, P = .09). Analysis of multiple clinical variables suggests that increased weight gain was associated with increased compensatory ipsilateral lung volume growth (ρ = 0.57, P = .05). CONCLUSIONS: These results suggest a potential for postnatal catch-up growth in infants with pulmonary hypoplasia and suggest that weight gain may increase the volume growth of the more severely affected lung.
OBJECTIVE: To evaluate postnatal lung volume in infants with congenital diaphragmatic hernia (CDH) and determine if a compensatory increase in lung volume occurs during the postnatal period. STUDY DESIGN: Using a novel pulmonary magnetic resonance imaging method for imaging neonatal lungs, the postnatal lung volumes in infants with CDH were determined and compared with prenatal lung volumes obtained via late gestation magnetic resonance imaging. RESULTS:Infants with left-sided CDH (2 mild, 9 moderate, and 1 severe) were evaluated. The total lung volume increased in all infants, with the contralateral lung increasing faster than the ipsilateral lung (mean ± SD: 4.9 ± 3.0 mL/week vs 3.4 ± 2.1 mL/week, P = .005). In contrast to prenatal studies, the volume of lungs of infants with more severe CDH grew faster than the lungs of infants with more mild CDH (Spearman's ρ=-0.086, P = .01). Although the contralateral lung volume grew faster in both mild and moderate groups, the majority of total lung volume growth in moderate CDH came from increased volume of the ipsilateral lung (42% of total lung volume increase in the moderate group vs 32% of total lung volume increase in the mild group, P = .09). Analysis of multiple clinical variables suggests that increased weight gain was associated with increased compensatory ipsilateral lung volume growth (ρ = 0.57, P = .05). CONCLUSIONS: These results suggest a potential for postnatal catch-up growth in infants with pulmonary hypoplasia and suggest that weight gain may increase the volume growth of the more severely affected lung.
Authors: Paul J Critser; Nara S Higano; Jean A Tkach; Emilia S Olson; David R Spielberg; Paul S Kingma; Robert J Fleck; Sean M Lang; Ryan A Moore; Michael D Taylor; Jason C Woods Journal: Am J Respir Crit Care Med Date: 2020-01-01 Impact factor: 21.405
Authors: Nara S Higano; Robert P Thomen; James D Quirk; Heidie L Huyck; Andrew D Hahn; Sean B Fain; Gloria S Pryhuber; Jason C Woods Journal: Neonatology Date: 2020-11-11 Impact factor: 4.035