Effects of tracheal occlusion on the neonatal cardiopulmonary transition in an ovine model of diaphragmatic hernia
Philip LJ DeKoninck, Kelly J Crossley, Aidan J Kashyap, Sasha M Skinner, Marta Thio, Karyn A Rodgers, Jan A Deprest, Stuart B Hooper, Ryan J Hodges
Archives of Disease in Childhood - Fetal and Neonatal Edition | BMJ PUBLISHING GROUP | Published : 2019
OBJECTIVE: Fetoscopic endoluminal tracheal occlusion (FETO) aims to reverse pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH) and mitigate the associated respiratory insufficiency and pulmonary hypertension after birth. We aimed to determine whether FETO improves the cardiopulmonary transition at birth in an ovine model of CDH. METHODS: In 12 ovine fetuses with surgically induced diaphragmatic hernia (DH; 80 dGA), an endotracheal balloon was placed tracheoscopically at ≈110 dGA and removed at ≈131 dGA (DH+FETO), while 10 were left untreated (DH). At ≈138 dGA, all lambs (survival at delivery: 67% [DH+FETO], 70% [DH]) were delivered via caesarean section and ventilated..View full abstract
This research project was funded by grants from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Foundation, Cabrini Foundation, CDH Australia and the Victorian Government's Operational Infrastructure Support Program. JDP is supported by a grant of the Great Ormond Street Hospital Charity Fund.