Faculty Collaboration Database

Pulmonary vascular resistance in repaired congenital diaphragmatic hernia vs. age-matched controls. Pediatr Res 2012 Jun;71(6):697-700

Date

03/30/2012

Pubmed ID

22456633

DOI

10.1038/pr.2012.16

Scopus ID

2-s2.0-84861350719 (requires institutional sign-in at Scopus site)   22 Citations

Abstract

INTRODUCTION: Infants and children with repaired congenital diaphragmatic hernia (CDH) often continue to show delayed growth and development that may be, in part, secondary to unrecognized persistence of increased pulmonary vascular resistance (PVR).

METHODS: Data were reviewed from all patients ages 6-36 mo with repaired CDH who underwent cardiac catheterization from 2007 to 2010 and were compared to data from a control population of patients undergoing percutaneous closure of a patent ductus arteriosus (PDA). Indexed pulmonary blood flow (Qp), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and PVR were examined.

RESULTS: Data from 8 CDH patients and 10 control patients were examined. The mPAP (22.5 ± 3.33 vs. 18.2 ± 4.13 mm Hg) and PVR (3.66 ± 0.79 vs. 1.22 ± 0.4 iwU (indexed Wood's units)) were both significantly elevated in the CDH population, whereas the Qp (4.08 ± 1.43 vs. 6.82 ± 1.46 l/min/m(2)) was significantly lower in this population. There was no significant difference in pulmonary capillary wedge pressure (PCWP). Less than half of the CDH patients had signs of pulmonary hypertension (PH) on echocardiogram.

DISCUSSION: Our data suggest that children who are ages 6-36 mo with repaired CDH have significantly increased PVR compared with controls and early consideration of cardiac catheterization may be warranted.

Author List

Zussman ME, Bagby M, Benson DW, Gupta R, Hirsch R

MESH terms used to index this publication - Major topics in bold

Cardiac Catheterization
Case-Control Studies
Child, Preschool
Ductus Arteriosus, Patent
Echocardiography
Female
Hemodynamics
Hernia, Diaphragmatic
Hernias, Diaphragmatic, Congenital
Humans
Infant
Male
Pulmonary Wedge Pressure
Retrospective Studies
Vascular Resistance