Lower Distending Pressure Improves Respiratory Mechanics in Congenital Diaphragmatic Hernia Complicated by Persistent Pulmonary Hypertension

To investigate the effects of distending pressures on respiratory mechanics and pulmonary circulation in newborn infants with congenital diaphragmatic hernia (CDH) and persistent pulmonary hypertension (PPHN). In total, 17 consecutive infants of ≥37 weeks of gestational age with CDH and PPHN were in...

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Bibliographic Details
Published in:The Journal of pediatrics 2018-09, Vol.200, p.38-43
Main Authors: Guevorkian, David, Mur, Sebastien, Cavatorta, Eric, Pognon, Laurence, Rakza, Thameur, Storme, Laurent
Format: Article
Language:English
Subjects:
congenital diaphragmatic hernia
persistent pulmonary hypertension
positive end-expiratory pressure
respiratory mechanics
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Summary:To investigate the effects of distending pressures on respiratory mechanics and pulmonary circulation in newborn infants with congenital diaphragmatic hernia (CDH) and persistent pulmonary hypertension (PPHN). In total, 17 consecutive infants of ≥37 weeks of gestational age with CDH and PPHN were included in this prospective, randomized, crossover pilot study. Infants were assigned randomly to receive 2 or 5 cmH2O of positive end-expiratory pressure (PEEP) for 1 hour in a crossover design. The difference between peak inspiratory pressure and PEEP was kept constant. Respiratory mechanics, lung function, and hemodynamic variables assessed by Doppler echocardiography were measured after each study period. At 2 cmH2O of PEEP, tidal volume and minute ventilation were greater (P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2018.04.027