Research: Neonatal rodent ventilation and clinical correlation in congenital diaphragmatic hernia

Pediatr Pulmonol

. 2022 Mar 30. doi: 10.1002/ppul.25911. Online ahead of print.

Neonatal rodent ventilation and clinical correlation in congenital diaphragmatic hernia

Vikas S Gupta 1Cory Wilson 2Elizabeth C Popp 1 3Siqin Zhaorigetu 1Scott Collum 2Di Jin 1Amir M Khan 3Harry Karmouty-Quintana 2Kevin P Lally 1Matthew T Harting 1Affiliations expand


Introduction: Ventilator management is a critical part of managing congenital diaphragmatic hernia (CDH). We aimed to use a murine model and patient data to study CDH-associated differences in oxygenation, airway resistance, and pulmonary mechanics by disease severity.

Methods: We used the nitrofen model of CDH. For control and CDH rodents, data were collected within the first hour of life. Oxygen saturations (SpO2 ) were collected using MouseOx, and large airway resistance and inspiratory capacities were collected using FlexiVent. A single-center, retrospective review of term CDH infants from 2014-2020 was performed. Tidal volumes were collected every 6 hours for the first 48 hours of life or until the patient was taken off conventional ventilation. Newborns that were mechanically ventilated but had no pulmonary pathology were used as controls. CDH severity was defined using CDH Study Group (CDHSG) classification system.

Results: Control rodents had a median SpO2 of 94%(IQR 88-98%); CDH pups had a median SpO2 of 27.9% (IQR 22-30%)(p<0.01). CDH rodents had lower inspiratory capacity than controls (median 110μL,IQR 70-170 vs. median 267μL,IQR 216-352;p<0.01). CDH infants had a lower initial SpO2 than control infants. Overall, CDH infants had lower tidal volumes than control infants (median 4.2mL/kg, IQR 3.3-5.0 vs. 5.4mL/kg, IQR 4.7-6.2;p=0.03). Tidal volumes varied by CDHSG stage.

Conclusion: Newborns with CDH have lower SpO2 and lower, CDHSG stage specific, tidal volumes than control infants. The nitrofen model of CDH reflects these differences. Rodent models may be useful in studying therapeutic ventilatory strategies for CDH infants. This article is protected by copyright. All rights reserved.

Keywords: Congenital diaphragmatic hernia; hypoxia; neonatology; pulmonary function; ventilation.

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