Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia
ObjectiveTo evaluate whether the patent ductus arteriosus (PDA) can serve as a predictive factor for inpatient outcomes in congenital diaphragmatic hernia (CDH) patients.MethodsA retrospective cohort study was conducted on 59 CDH patients at the Capital Institute of Pediatrics from January 2020 to A...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1272052/full |
| _version_ | 1797644200411398144 |
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| author | Min Bao Tao Wu Jinghui Guo Ying Wang Aimei Cao Chao Liu Yandong Wei Chunhua Zheng Lin Shi Lishuang Ma |
| author_facet | Min Bao Tao Wu Jinghui Guo Ying Wang Aimei Cao Chao Liu Yandong Wei Chunhua Zheng Lin Shi Lishuang Ma |
| author_sort | Min Bao |
| collection | DOAJ |
| description | ObjectiveTo evaluate whether the patent ductus arteriosus (PDA) can serve as a predictive factor for inpatient outcomes in congenital diaphragmatic hernia (CDH) patients.MethodsA retrospective cohort study was conducted on 59 CDH patients at the Capital Institute of Pediatrics from January 2020 to August 2022. Echocardiography was performed at least three times: within 2–3 h after birth, pre-operatively, and post-operatively of CDH surgery. Based on the direction of the PDA shunt in the first echocardiogram, patients were classified into three groups: left-to-right shunting or closed PDA (L-R), bi-directional shunting, and right-to-left shunting (R-L).ResultsThe mortality rate was 15.3% (9/59), with all non-survivors having R-L shunting and group mortality of 39.1% (9/23). The direction of the PDA shunt was significantly associated with the duration of ventilation and length of hospital stay (p < 0.05). Decreased PDA diameter or pre-operative shunting direction change towards L-R or bi-directional shunting were associated with higher survival rates, while increased PDA diameter or continuous R-L shunting were associated with higher mortality rates. Pre-operative PDA shunt direction, PDA size after birth and before surgery, gestational age of diagnosis, and shortening fraction before surgery were significantly correlated with patient outcomes. The direction of the preoperative PDA shunt was the most relevant factor among these relationships (p = 0.009, OR 20.6, CI 2.2∼196.1).ConclusionOur findings highlight the importance of monitoring changes in PDA shunt directionality and diameter in the early stage after birth, as these parameters may serve as valuable predictors of patient outcomes. |
| first_indexed | 2024-03-11T14:27:02Z |
| format | Article |
| id | doaj.art-4383c41b30324461bdaa0296bb3c183d |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T14:27:02Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-4383c41b30324461bdaa0296bb3c183d2023-10-31T14:55:54ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-10-011110.3389/fped.2023.12720521272052Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic herniaMin Bao0Tao Wu1Jinghui Guo2Ying Wang3Aimei Cao4Chao Liu5Yandong Wei6Chunhua Zheng7Lin Shi8Lishuang Ma9Department of Cardiology, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Pediatric and Neonatal Surgery, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Cardiology, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Pediatric and Neonatal Surgery, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Cardiology, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Pediatric and Neonatal Surgery, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Pediatric and Neonatal Surgery, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Cardiology, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Cardiology, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaDepartment of Pediatric and Neonatal Surgery, Children's Hospital in Capital Institute of Pediatrics, Beijing, ChinaObjectiveTo evaluate whether the patent ductus arteriosus (PDA) can serve as a predictive factor for inpatient outcomes in congenital diaphragmatic hernia (CDH) patients.MethodsA retrospective cohort study was conducted on 59 CDH patients at the Capital Institute of Pediatrics from January 2020 to August 2022. Echocardiography was performed at least three times: within 2–3 h after birth, pre-operatively, and post-operatively of CDH surgery. Based on the direction of the PDA shunt in the first echocardiogram, patients were classified into three groups: left-to-right shunting or closed PDA (L-R), bi-directional shunting, and right-to-left shunting (R-L).ResultsThe mortality rate was 15.3% (9/59), with all non-survivors having R-L shunting and group mortality of 39.1% (9/23). The direction of the PDA shunt was significantly associated with the duration of ventilation and length of hospital stay (p < 0.05). Decreased PDA diameter or pre-operative shunting direction change towards L-R or bi-directional shunting were associated with higher survival rates, while increased PDA diameter or continuous R-L shunting were associated with higher mortality rates. Pre-operative PDA shunt direction, PDA size after birth and before surgery, gestational age of diagnosis, and shortening fraction before surgery were significantly correlated with patient outcomes. The direction of the preoperative PDA shunt was the most relevant factor among these relationships (p = 0.009, OR 20.6, CI 2.2∼196.1).ConclusionOur findings highlight the importance of monitoring changes in PDA shunt directionality and diameter in the early stage after birth, as these parameters may serve as valuable predictors of patient outcomes.https://www.frontiersin.org/articles/10.3389/fped.2023.1272052/fullcongenital diaphragmatic herniaechocardiographyneonatal outcomespatent ductous arteriosuspulmonary hypertension |
| spellingShingle | Min Bao Tao Wu Jinghui Guo Ying Wang Aimei Cao Chao Liu Yandong Wei Chunhua Zheng Lin Shi Lishuang Ma Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia Frontiers in Pediatrics congenital diaphragmatic hernia echocardiography neonatal outcomes patent ductous arteriosus pulmonary hypertension |
| title | Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| title_full | Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| title_fullStr | Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| title_full_unstemmed | Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| title_short | Patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| title_sort | patent ductus arteriosus shunting direction and diameter predict inpatient outcomes in newborns with congenital diaphragmatic hernia |
| topic | congenital diaphragmatic hernia echocardiography neonatal outcomes patent ductous arteriosus pulmonary hypertension |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1272052/full |
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