The Journal of pediatrics · 2026
Initial Hemodynamic Phenotypes and Clinical Trajectory in Congenital Diaphragmatic Hernia: A Pilot Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wren John T, Hyland Rachael M, Mcnamara Patrick J
Аннотация
OBJECTIVES: To define clinically the initial (<24 hour) hemodynamic phenotypes (no/mild pulmonary hypertension [PH], precapillary PH, and postcapillary PH) in neonates with congenital diaphragmatic hernia (CDH) by echocardiography, and to assess their relationship with clinical outcomes.
STUDY DESIGN: This was a retrospective, single-center, observational study that included all neonates with CDH with an echocardiogram in the first 24 hours from 2018 to 2025. Phenotypes were categorized via an a priori-defined algorithm, characterized by clinical and echocardiography indices and were evaluated for association with mortality, need for extracorporeal life support, and key clinical outcomes.
RESULTS: Despite bidirectional atrial and/or ductal shunts in every echocardiogram (n = 28), phenotype identification was feasible with 2 (7%) no/mild PH, 18 (64%) precapillary PH, and 8 (29%) postcapillary PH phenotype. There was no association between phenotype and mortality or extracorporeal life support; however, the postcapillary phenotype was associated with earlier mortality, decreased surgical repair, and mortality when exposed to inhaled nitric oxide.
CONCLUSIONS: An algorithmic approach that includes early echocardiography can reliably identify hemodynamic phenotypes even in the presence of bidirectional shunts. Phenotypes may have distinct clinical trajectories in neonates with CDH.
STUDY DESIGN: This was a retrospective, single-center, observational study that included all neonates with CDH with an echocardiogram in the first 24 hours from 2018 to 2025. Phenotypes were categorized via an a priori-defined algorithm, characterized by clinical and echocardiography indices and were evaluated for association with mortality, need for extracorporeal life support, and key clinical outcomes.
RESULTS: Despite bidirectional atrial and/or ductal shunts in every echocardiogram (n = 28), phenotype identification was feasible with 2 (7%) no/mild PH, 18 (64%) precapillary PH, and 8 (29%) postcapillary PH phenotype. There was no association between phenotype and mortality or extracorporeal life support; however, the postcapillary phenotype was associated with earlier mortality, decreased surgical repair, and mortality when exposed to inhaled nitric oxide.
CONCLUSIONS: An algorithmic approach that includes early echocardiography can reliably identify hemodynamic phenotypes even in the presence of bidirectional shunts. Phenotypes may have distinct clinical trajectories in neonates with CDH.