Seminars in Fetal & Neonatal Medicine最新文献_第6页

Introduction to Seminars in Fetal and Neonatal Medicine, Congenital Diaphragmatic Hernia issue 胎儿和新生儿医学研讨会介绍，先天性膈疝问题。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-09-13 DOI: 10.1016/j.siny.2025.101661

Neil Patel

引用次数: 0

What is the role of echocardiography in newborns with CDH? 超声心动图在新生儿CDH中的作用是什么？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-08-22 DOI: 10.1016/j.siny.2025.101657

María V. Fraga , Gabriel Altit , Bradley A. Yoder , Shazia Bhombal

引用次数: 0

Cardiorespiratory transition in CDH CDH的心肺过渡。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-07-01 DOI: 10.1016/j.siny.2025.101649

Deepika Sankaran , Satyan Lakshminrusimha , Michelle J. Lim

{"title":"Cardiorespiratory transition in CDH","authors":"Deepika Sankaran , Satyan Lakshminrusimha , Michelle J. Lim","doi":"10.1016/j.siny.2025.101649","DOIUrl":"10.1016/j.siny.2025.101649","url":null,"abstract":"<div><div>Congenital diaphragmatic hernia<span><span> (CDH) is a rare congenital anomaly that occurs due to incomplete closure of the diaphragm followed by herniation of abdominal contents into the chest. Fetal </span>hemodynamics<span><span><span><span> are altered in CDH due to pulmonary alveolar and vascular hypoplasia<span>, low pulmonary venous return and in some cases, hypoplasia or dysfunction of the left heart. CDH is associated with high risk of morbidity and mortality due to </span></span>pulmonary hypoplasia and </span>persistent pulmonary hypertension<span> of the newborn secondary to pulmonary vascular hypoplasia and remodeling. Resuscitation in the delivery room involves optimizing cardiopulmonary transition from fetal to neonatal circulation through gentle ventilation, </span></span>endotracheal intubation<span><span><span> and gastric decompression. Infants with CDH often present with hypoxemic respiratory failure in the immediate postnatal period due to pulmonary hypertension. The understanding of critical cardiopulmonary interactions and the distinguishing features of CDH sub-phenotypes and degree of cardiac involvement may aid in an augmented precision-based approach to </span>invasive ventilation, vasoactive use, and </span>ECMO management. Improved survival is reported after fetal in-utero interventions such as fetoscopic endoluminal tracheal occlusion (FETO) with CDH and severe secondary pulmonary hypoplasia. Clinical outcomes can potentially be improved by optimizing cardiopulmonary transition in the delivery room and cardiopulmonary interactions in the immediate the postnatal period.</span></span></span></div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101649"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565363","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

Nutrition in congenital diaphragmatic hernia: How and when? 先天性膈疝的营养：如何及何时？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-07-01 DOI: 10.1016/j.siny.2025.101650

Ulla Lei Larsen , John T. Wren Jr. , Christy Gilcrease , Mark Bremholm Ellebaek , Patrick E. Sloan

{"title":"Nutrition in congenital diaphragmatic hernia: How and when?","authors":"Ulla Lei Larsen , John T. Wren Jr. , Christy Gilcrease , Mark Bremholm Ellebaek , Patrick E. Sloan","doi":"10.1016/j.siny.2025.101650","DOIUrl":"10.1016/j.siny.2025.101650","url":null,"abstract":"<div><div>Survival for infants with congenital diaphragmatic hernia<span><span> (CDH) has improved, but they continue to face significant nutritional morbidity. They are at risk of growth failure, malnutrition, gastroesophageal reflux disease<span><span><span> (GERD), oral aversion, and the need for nutritional tube feeding support after the initial hospitalization. Malnutrition and poor nutritional outcomes impact </span>neurodevelopment, underlining the importance of addressing these issues. Available evidence in this area is scarce, and controversies remain about the timing and mode of </span>enteral feeding in the peri-operative period, the role of enteral nutrition on </span></span>extracorporeal membrane oxygenation (ECMO), and nutritional growth targets for infants with CDH.</span></div><div>In this manuscript, we discuss enteral and parenteral targets for infants with CDH, growth targets, the timing and advancement of enteral feeding. In addition, we discuss post-discharge nutritional support, identify gaps in the current literature and address parental concerns around nutrition and growth in infants with CDH.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101650"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565364","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 assessment and prediction in CDH: for what purpose? CDH的产前评估和预测：目的是什么？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-07-09 DOI: 10.1016/j.siny.2025.101654

Maëlig Abgral , Francesca M. Russo , Jan Deprest , Alexandra Benachi

{"title":"Prenatal assessment and prediction in CDH: for what purpose?","authors":"Maëlig Abgral , Francesca M. Russo , Jan Deprest , Alexandra Benachi","doi":"10.1016/j.siny.2025.101654","DOIUrl":"10.1016/j.siny.2025.101654","url":null,"abstract":"<div><div>Congenital diaphragmatic hernia is most often diagnosed prenatally, and accurate assessment is crucial for prognosis parental counselling and therapeutic planning. The assessment of pulmonary hypoplasia is currently the most relevant prognostic indicator. Ultrasound and MRI parameters such as the observed-to-expected lung-to-head ratio and total fetal lung volume serve as the primary predictors of neonatal outcome. However, these markers are not predictive of associated complications like persistent pulmonary hypertension of neonates and cardiac dysfunction, which also significantly influence survival and morbidity. Although new imaging parameters have been proposed, their clinical utility is limited by insufficient validation and inter-center variability. This review critically evaluates current prenatal imaging methods for congenital diaphragmatic hernia, highlighting their strengths and limitations. A better understanding of the underlying pathophysiology, alongside efforts to develop standardized, reproducible and eventually predictive markers, is essential to refine prognosis, optimize fetal therapy selection, eventually improving outcomes for affected neonates.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101654"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718975","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

Developmental pathophysiology and genetic contributions in CDH CDH的发育病理生理和遗传贡献。

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-07-01 DOI: 10.1016/j.siny.2025.101652

Gabriel Guevara , K. Taylor Wild , Richard Keijzer , David J. McCulley

引用次数: 0

Management of Congenital Diaphragmatic Hernia (CDH) care: Addressing what matters to patients and their families? 先天性膈疝（CDH）护理的管理：解决什么对患者及其家属重要？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-07-01 DOI: 10.1016/j.siny.2025.101651

K. Saint Denny , J. Lawer , S. Mur , T.M. Prentice

引用次数: 0

“Gentle” cardio-respiratory management in congenital diaphragmatic hernia: Time for a precision-medicine approach? 先天性膈疝的“温和”心肺管理：是时候采用精准医学方法了？

IF 2.8 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-10-01 Epub Date: 2025-09-19 DOI: 10.1016/j.siny.2025.101660

Anna Foth , David Tingay , Florian Kipfmueller

{"title":"“Gentle” cardio-respiratory management in congenital diaphragmatic hernia: Time for a precision-medicine approach?","authors":"Anna Foth , David Tingay , Florian Kipfmueller","doi":"10.1016/j.siny.2025.101660","DOIUrl":"10.1016/j.siny.2025.101660","url":null,"abstract":"<div><div>Congenital diaphragmatic hernia (CDH) remains one of the most challenging conditions to manage in neonatal intensive care, with outcomes determined by the complex interplay between pulmonary hypoplasia, pulmonary vascular remodeling, and ventricular dysfunction. Traditional treatment strategies, including high-frequency ventilation, inhaled nitric oxide, and vasopressor use, fail to account for the dynamic heterogeneity of CDH physiology and may contribute to persistently high mortality. Emerging evidence delineates three principal hemodynamic phenotypes: (1) preserved biventricular function with mild/no pulmonary hypertension (PH), (2) pre-capillary PH with or without right ventricular dysfunction, and (3) post-capillary PH with primary left ventricular (LV) dysfunction. Each phenotype demands distinct ventilatory and pharmacologic strategies, ranging from cautious respiratory support to targeted pulmonary vasodilators, inodilators, or LV-directed therapies. Ventilation in CDH is further complicated by profound lung inhomogeneity, the “baby lung” phenomenon, and susceptibility to ventilator-induced lung injury. Advances in lung-protective strategies, including low driving pressure, permissive hypercapnia, synchrony-enhancing modes, and real-time functional monitoring with echocardiography, lung ultrasound, electrical impedance tomography, and use of circulating biomarkers enable tailored interventions. A precision medicine approach, grounded in multimodal monitoring and gentle cardiopulmonary support, holds promise to optimize hemodynamic balance, reduce iatrogenic injury, and improve survival and long-term outcomes in infants with CDH.</div></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"30 3","pages":"Article 101660"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259889","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

Post-discharge nutrition to optimize preterm infant short- and long-term outcomes 出院后营养优化早产儿短期和长期结局。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-07-01 Epub Date: 2025-04-09 DOI: 10.1016/j.siny.2025.101637

Sarah N. Taylor, Catherine O. Buck

引用次数: 0

Use of human milk and fortification in the neonatal intensive care unit 在新生儿重症监护病房使用母乳和强化。

IF 2.9 3区医学

Seminars in Fetal & Neonatal Medicine Pub Date : 2025-07-01 Epub Date: 2025-05-13 DOI: 10.1016/j.siny.2025.101632

David H. Adamkin

引用次数: 0