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Seminars in Pediatric Surgery最新文献

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Exploring the state of the art and science in congenital diaphragmatic hernia 探索先天性膈疝的技术和科学现状
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-03 DOI: 10.1016/j.sempedsurg.2024.151435
Matthew T. Harting, Kevin P. Lally
{"title":"Exploring the state of the art and science in congenital diaphragmatic hernia","authors":"Matthew T. Harting, Kevin P. Lally","doi":"10.1016/j.sempedsurg.2024.151435","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2024.151435","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151435"},"PeriodicalIF":1.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac function in congenital diaphragmatic hernia 先天性膈疝的心脏功能
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-03 DOI: 10.1016/j.sempedsurg.2024.151438
Gabriel Altit , Anie Lapointe , Florian Kipfmueller , Neil Patel
{"title":"Cardiac function in congenital diaphragmatic hernia","authors":"Gabriel Altit ,&nbsp;Anie Lapointe ,&nbsp;Florian Kipfmueller ,&nbsp;Neil Patel","doi":"10.1016/j.sempedsurg.2024.151438","DOIUrl":"10.1016/j.sempedsurg.2024.151438","url":null,"abstract":"<div><p>Cardiac function is known to play critical role in the pathophysiological progression and ultimate clinical outcome of patients with congenital diaphragmatic hernia (CDH). While often anatomically normal, the fetal and neonatal heart in CDH can suffer from both right and left ventricular dysfunction. Here we explore the abnormal fetal heart, early postnatal right and left ventricular dysfunction, the interplay between cardiac dysfunction and pulmonary hypertension, evaluation and echocardiographic assessment of the heart, and therapeutic strategies for managing and supporting the pathophysiologic heart and CDH. Further, we take a common clinical scenario and provide clinically relevant guidance for the diagnosis and management of this complex process.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151438"},"PeriodicalIF":1.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical approaches to congenital diaphragmatic hernia 先天性膈疝的手术方法。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151441
Sarah King , Benjamin D.E. Carr , George B. Mychaliska , Joseph T. Church
{"title":"Surgical approaches to congenital diaphragmatic hernia","authors":"Sarah King ,&nbsp;Benjamin D.E. Carr ,&nbsp;George B. Mychaliska ,&nbsp;Joseph T. Church","doi":"10.1016/j.sempedsurg.2024.151441","DOIUrl":"10.1016/j.sempedsurg.2024.151441","url":null,"abstract":"<div><p>Surgical repair of the diaphragm is essential for survival in congenital diaphragmatic hernia (CDH). There are many considerations surrounding the operation – why the operation matters, optimal timing of repair and its relation to extracorporeal life support (ECLS) use, minimally invasive versus open approaches, and strategies for reconstruction. Surgery is both affected by, and affects, the physiology of these infants and is an important factor in determining long-term outcomes. Here we discuss the evidence and provide insight surrounding this complex decision making, technical pearls, and outcomes in repair of CDH.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151441"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prenatal diagnostic and intervention considerations in congenital diaphragmatic hernia 先天性膈疝的产前诊断和干预注意事项
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151436
Claudia Ibarra , Eric Bergh , Kuojen Tsao , Anthony Johnson
{"title":"Prenatal diagnostic and intervention considerations in congenital diaphragmatic hernia","authors":"Claudia Ibarra ,&nbsp;Eric Bergh ,&nbsp;Kuojen Tsao ,&nbsp;Anthony Johnson","doi":"10.1016/j.sempedsurg.2024.151436","DOIUrl":"10.1016/j.sempedsurg.2024.151436","url":null,"abstract":"<div><p>Congenital diaphragmatic hernia (CDH) is a life-threatening birth defect with significant morbidity and mortality. The prenatal management of a pregnancy with a fetus affected with CDH is complex and requires a multi-disciplinary team approach. An improved understanding of prenatal diagnosis and management is essential to developing strategies to optimize outcomes for these patients. In this review, we explore the current knowledge on diagnosis, severity stratification, prognostic prediction, and indications for fetal intervention in the fetus with CDH.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151436"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of ECLS in the management of congenital diaphragmatic hernia ECLS 在治疗先天性膈疝中的作用
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151440
Yigit S. Guner , JD Hammond , Sarah Keene , Brian Gray
{"title":"The role of ECLS in the management of congenital diaphragmatic hernia","authors":"Yigit S. Guner ,&nbsp;JD Hammond ,&nbsp;Sarah Keene ,&nbsp;Brian Gray","doi":"10.1016/j.sempedsurg.2024.151440","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2024.151440","url":null,"abstract":"<div><p>In the complex arena of Congenital Diaphragmatic Hernia (CDH) management, Extracorporeal Life Support (ECLS) provides a strategic window for stabilization and surgical correction, during which time marginal gains in patient stability can tip the scales towards survival. In modern neonatal ECLS, the focus is increasingly on minimizing survivor morbidity, which calls for considerable multidisciplinary expertise to enhance patient outcomes. This review will delve into the most up-to-date literature on the management of CDH in the context of ECLS, providing a comprehensive synthesis of current insights.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151440"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1055858624000611/pdfft?md5=e07bdab4a08a84afa8262d867ac59437&pid=1-s2.0-S1055858624000611-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Congenital diaphragmatic hernia-associated pulmonary hypertension 先天性膈疝相关性肺动脉高压
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151437
Kylie I. Holden , Natalie E. Rintoul , Patrick J. McNamara , Matthew T. Harting
{"title":"Congenital diaphragmatic hernia-associated pulmonary hypertension","authors":"Kylie I. Holden ,&nbsp;Natalie E. Rintoul ,&nbsp;Patrick J. McNamara ,&nbsp;Matthew T. Harting","doi":"10.1016/j.sempedsurg.2024.151437","DOIUrl":"10.1016/j.sempedsurg.2024.151437","url":null,"abstract":"<div><p>Congenital diaphragmatic hernia (CDH) is characterized by a developmental insult which compromises cardiopulmonary embryology and results in a diaphragmatic defect, allowing abdominal organs to herniate into the hemithorax. Among the significant pathophysiologic components of this condition is pulmonary hypertension (PH), alongside pulmonary hypoplasia and cardiac dysfunction. Fetal pulmonary vascular development coincides with lung development, with the pulmonary vasculature evolving alongside lung maturation. However, in CDH, this embryologic development is impaired which, in conjunction with external compression, stifle pulmonary vascular maturation, leading to reduced lung density, increased muscularization of the pulmonary vasculature, abnormal vascular responsiveness, and altered molecular signaling, all contributing to pulmonary arterial hypertension. Understanding CDH-associated PH (CDH-PH) is crucial for development of novel approaches and effective management due to its significant impact on morbidity and mortality. Antenatal and postnatal diagnostic methods aid in CDH risk stratification and, specifically, pulmonary hypertension, including fetal imaging and gas exchange assessments. Management strategies include lung protective ventilation, fluid optimization, pharmacotherapies including pulmonary vasodilators and hemodynamic support, and extracorporeal life support (ECLS) for refractory cases. Longitudinal re-evaluation is an important consideration due to the complexity and dynamic nature of CDH cardiopulmonary physiology. Emerging therapies such as fetal endoscopic tracheal occlusion and pharmacological interventions targeting key CDH pathophysiological mechanisms show promise but require further investigation. The complexity of CDH-PH underscores the importance of a multidisciplinary approach for optimal patient care and improved outcomes.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151437"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ventilator strategies in congenital diaphragmatic hernia 先天性膈疝的呼吸机策略。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151439
Shaun M. Kunisaki , Suneetha Desiraju , Michelle J. Yang , Satyan Lakshminrusimha , Bradley A. Yoder
{"title":"Ventilator strategies in congenital diaphragmatic hernia","authors":"Shaun M. Kunisaki ,&nbsp;Suneetha Desiraju ,&nbsp;Michelle J. Yang ,&nbsp;Satyan Lakshminrusimha ,&nbsp;Bradley A. Yoder","doi":"10.1016/j.sempedsurg.2024.151439","DOIUrl":"10.1016/j.sempedsurg.2024.151439","url":null,"abstract":"<div><p>This review focuses on contemporary mechanical ventilator practices used in the initial management of neonates born with congenital diaphragmatic hernia (CDH). Both conventional and non-conventional ventilation modes in CDH are reviewed. Special emphasis is placed on the rationale for gentle ventilation and the current evidence-based clinical practice guidelines that are recommended for supporting these fragile infants. The interplay between CDH lung hypoplasia and other key cardiopulmonary elements of the disease, namely a reduced pulmonary vascular bed, abnormal pulmonary vascular remodeling, and left ventricular hypoplasia, are discussed. Finally, we provide insights into future avenues for mechanical ventilator research in CDH.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151439"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term follow-up in congenital diaphragmatic hernia 先天性膈疝的长期随访。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151443
Jessica C. Pollack , Laura E. Hollinger , Terry L. Buchmiller , Tim Jancelewicz
{"title":"Long-term follow-up in congenital diaphragmatic hernia","authors":"Jessica C. Pollack ,&nbsp;Laura E. Hollinger ,&nbsp;Terry L. Buchmiller ,&nbsp;Tim Jancelewicz","doi":"10.1016/j.sempedsurg.2024.151443","DOIUrl":"10.1016/j.sempedsurg.2024.151443","url":null,"abstract":"<div><p>With improvements in initial care for patients with congenital diaphragmatic hernia (CDH), the number of CDH patients with severe disease who are surviving to discharge has increased. This growing population of patients faces a unique set of long-term challenges, multisystem adverse outcomes, and post-intervention complications requiring specialized multidisciplinary follow-up. Early identification and intervention are essential to mitigate the potential morbidity associated with these challenges. This manuscript outlines a general framework for long-term follow-up for the CDH patient, including cardiopulmonary, gastrointestinal, neurodevelopmental, surgical, and quality of life outcomes.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151443"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The promise and pitfalls of care standardization in congenital diaphragmatic hernia 先天性膈疝护理标准化的前景与陷阱。
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151445
Alexandra Dimmer , Rebecca Stark , Erik D. Skarsgard , Pramod S. Puligandla
{"title":"The promise and pitfalls of care standardization in congenital diaphragmatic hernia","authors":"Alexandra Dimmer ,&nbsp;Rebecca Stark ,&nbsp;Erik D. Skarsgard ,&nbsp;Pramod S. Puligandla","doi":"10.1016/j.sempedsurg.2024.151445","DOIUrl":"10.1016/j.sempedsurg.2024.151445","url":null,"abstract":"<div><p>The aim of standardizing care is to enhance patient outcomes and optimize healthcare delivery by minimizing variations in care and ensuring the efficient allocation of healthcare resources. Despite these potential benefits to patients, healthcare providers and the healthcare system, standardization may also disadvantage these groups. With a specific focus on congenital diaphragmatic hernia, this article will review the promise and pitfalls of standardization, as well as a potential path forward that uses standardization to improve outcomes in this rare and complex disease process.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151445"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cellular origins and translational approaches to congenital diaphragmatic hernia 先天性膈疝的细胞起源和转化方法
IF 1.4 3区 医学
Seminars in Pediatric Surgery Pub Date : 2024-07-02 DOI: 10.1016/j.sempedsurg.2024.151444
Marietta Jank , Fabian Doktor , Augusto Zani , Richard Keijzer
{"title":"Cellular origins and translational approaches to congenital diaphragmatic hernia","authors":"Marietta Jank ,&nbsp;Fabian Doktor ,&nbsp;Augusto Zani ,&nbsp;Richard Keijzer","doi":"10.1016/j.sempedsurg.2024.151444","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2024.151444","url":null,"abstract":"<div><p>Congenital Diaphragmatic Hernia (CDH) is a complex developmental abnormality characterized by abnormal lung development, a diaphragmatic defect and cardiac dysfunction. Despite significant advances in management of CDH, mortality and morbidity continue to be driven by pulmonary hypoplasia, pulmonary hypertension, and cardiac dysfunction. The etiology of CDH remains unknown, but CDH is presumed to be caused by a combination of genetic susceptibility and external/environmental factors. Current research employs multi-omics technologies to investigate the molecular profile and pathways inherent to CDH. The aim is to discover the underlying pathogenesis, new biomarkers and ultimately novel therapeutic targets. Stem cells and their cargo, non-coding RNAs and agents targeting inflammation and vascular remodeling have produced promising results in preclinical studies using animal models of CDH. Shortcomings in current therapies combined with an improved understanding of the pathogenesis in CDH have given rise to novel promising experimental treatments that are currently being evaluated in clinical trials. This review provides insight into current developments in translational research, ranging from the cellular origins of abnormal cardiopulmonary development in CDH and the identification of novel treatment targets in preclinical CDH models at the bench and their translation to clinical trials at the bedside.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 4","pages":"Article 151444"},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1055858624000659/pdfft?md5=2608522eb2b544b2c7d05611cf92f171&pid=1-s2.0-S1055858624000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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