Congenital diaphragmatic hernia: endotracheal fluid phospholipidic profile following tracheal occlusion in an experimental model

2017 ◽  
Vol 45 (2) ◽  
Author(s):  
Gloria Pelizzo ◽  
Maria Chiara Mimmi ◽  
Jose Luis Peiro ◽  
Mario Marotta ◽  
Francesco Amoroso ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Partial Recovery ◽  
Lung Maturation ◽  
Tracheal Occlusion ◽  
Dipalmitoyl Phosphatidylcholine ◽  
Recovery Profile ◽  
Profile Changes ◽  
Lung Maturity

AbstractObjective:To compare endotracheal fluid (EF) and amniotic fluid (AF) phospholipidic profile changes following tracheal occlusion (TO) in the congenital diaphragmatic hernia (CDH) fetal lamb model, in order to support the efficacy of TO on lung maturity.Methods:A diaphragmatic defect was induced at 70 days’ gestation, TO was carried out at day 102 and cesarean section at 136 days’ gestation. EF and AF samples, collected at delivery, were evaluated using mass spectrometry (the analysis focused on palmitoyloleoyl-phosphatidylcholine [POPC, PC(18:1/16:0)], dipalmitoyl-phosphatidylcholine [DPPC, PC(16:0/16:0)] and sphingomyelins [SMs]).Results:The effects of CDH and TO were different on AF and EF. POPC levels were higher than DPPC levels in AF of healthy lambs. Following induction of the diaphragmatic malformation, an evident decrease in POPC was noted, while a substantial return to normal POPC levels and an increased DPPC peak were prompted by the TO. After CDH induction, a decrease in N-palmitoyl-D-sphingomyelin [SM(d18:1/16:0)] was revealed (P<0.01) and an increased peak in SMs in AF was prompted by the TO (P=0.05). While the most represented phosphatidylcholine (PC) species in EF of healthy lambs was DPPC, CDH induced a decrease in the DPPC peak and treatment with TO induced its partial recovery. SMs were detectable only in healthy EF samples.Conclusion:The phospholipid recovery profile following TO suggests the potential role of this therapy in restoring processes involved in surfactant-mediated lung maturation, even though other interactions involved in AF turnover should be considered. Moreover, these metabolites could be used as biomarkers of fetal pulmonary development.

scholarly journals Fetal Tracheal Occlusion in Lambs with Congenital Diaphragmatic Hernia: Role of Exogenous Surfactant at Birth

2005 ◽  
Vol 58 (4) ◽  
pp. 689-694 ◽  
Author(s):  
Andreana Bütter ◽  
Ioana Bratu ◽  
Hélène Flageole ◽  
Jean-Martin Laberge ◽  
Lajos Kovacs ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Exogenous Surfactant ◽  
Tracheal Occlusion

Magnetic Resonance Prediction of Lung Maturity in Fetuses With Congenital Diaphragmatic Hernia

2021 ◽  
Vol 37 (3) ◽  
pp. 272-277
Author(s):  
Eve Wiggins ◽  
Mladen Zecevic ◽  
Dan S. Hippe ◽  
Mariam Moshiri ◽  
Tom Winter ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Maturity

Fetoscopic tracheal occlusion for treatment of non-isolated congenital diaphragmatic hernia

2017 ◽  
Vol 37 (10) ◽  
pp. 1046-1049 ◽  
Author(s):  
Viola Seravalli ◽  
Eric B. Jelin ◽  
Jena L. Miller ◽  
Aylin Tekes ◽  
Luca Vricella ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Tracheal Occlusion

The role of ECMO in the management of congenital diaphragmatic hernia

2020 ◽  
Vol 44 (1) ◽  
pp. 151166
Author(s):  
Peter T. Yu ◽  
Howard C. Jen ◽  
Samuel Rice-Townsend ◽  
Yigit S. Guner
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia

scholarly journals Fetoscopic abdominal decompression of congenital diaphragmatic hernia – preliminary results of a fetal sheep model

2014 ◽  
Author(s):  
Felipe Fromm ◽  
Katharina Wenke ◽  
Thomas Krebs ◽  
Michael Boettcher ◽  
Georg Eschenburg ◽  
...  
Keyword(s):  
Animal Model ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Surgery ◽  
Amniotic Cavity ◽  
Sheep Model ◽  
Fetal Sheep ◽  
Tracheal Occlusion ◽  
Animal Trials ◽  
Abdominal Decompression

Background Severe congenital diaphragmatic hernia (CDH) is prenatally managed by fetoscopic tracheal occlusion (FETO) to improve lung growth and maturation. As FETO is not able to reduce the pressure onto the developing lungs originating from the intestine growing into the thoracic cavity, fetal abdominal decompression may alleviate this pressure effect by directing the growing intestine into the amniotic cavity away from the lungs. Therefore, aim of this study was to establish an animal model for fetoscopic abdominal decompression in fetal sheep with CDH. Methods CDH was created surgically on day 75 of 145 day gestation in eight fetuses. 2-3 weeks later, an opening was created in the fetal abdomen by fetoscopic surgery. The fetuses were retrieved by cesarean section at the end of pregnancy and evaluated. Results Five fetuses with CDH were treated with fetoscopic abdominal decompression. Three fetuses with CDH were taken as controls. One fetus was lost after creation of the CDH and two other after creation of the abdominal defect. Preliminary sterological results showed that the septal thickness of the experimental group was smaller than in the CDH group. Conclusion This study demonstrates the general feasibility of fetoscopic abdominal decompression for diaphragmatic hernia in our new animal model. Although not statistically significant, the lungs of treated fetuses were larger and heavier than those of untreated controls. Our findings support the hypothesis of palliative fetal surgery for severe CDH compared to tracheal occlusion. More controlled animal trials are needed.

scholarly journals Metabolomic profile of amniotic fluid to evaluate lung maturity: the diaphragmatic hernia lamb model

2014 ◽  
Vol 9 ◽  
Author(s):  
Gloria Pelizzo ◽  
Maurizio Ballico ◽  
Maria Chiara Mimmi ◽  
José Louis Peirò ◽  
Mario Marotta ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Diaphragmatic Hernia ◽  
Control Group ◽  
Metabolomic Profile ◽  
Lung Maturation ◽  
Metabolomic Profiling ◽  
Gestation Age ◽  
Alveolar Tissue ◽  
Global Growth ◽  
Lung Maturity

Background: Tracheal occlusion (TO) stimulates lung growth in fetuses affected with congenital diaphragmatic hernia (CDH) although the processes involved in lung maturation still remain unknown. The objective of this study was to evaluate the metabolomic profile of amniotic fluid (AF) following TO in fetal lamb model in order to obtain an indirect view of mechanisms involved in pulmonary reversal hypoplasia and biochemical maturity in response to fetal TO. Methods: Liquid Chromatography Mass Spectrometry was performed on lamb AF samples at: age I (70 days’gestation); age II (102 days’ gestation); age III (136 days’ gestation). CDH was induced at age I and TO at age II. Results: Betaine, choline, creatinine were found significantly increased during gestation in the control group. The CDH group showed choline (p =0.007) and creatinine (p =0.004) decreases during pregnancy. In the TO group choline and creatinine profiles were restored. Conclusions: Alveolar tissue and fetal global growth ameliorated after TO. Metabolomics provided useful information on biochemical details during lung maturation. Metabolomic profiling would help to identify the best time to perform TO, in order to increase survival of CDH affected patients.

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