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Pediatric Surgery International

Erschienen in:

23.03.2016 | Original Article

Effect of Perflubron-induced lung growth on pulmonary vascular remodeling in congenital diaphragmatic hernia

verfasst von: Mansi Shah, Michael R. Phillips, Benjamin Bryner, Ronald B. Hirschl, George B. Mychaliska, Sean E. McLean

Erschienen in: Pediatric Surgery International | Ausgabe 6/2016

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Abstract

Purpose

Congenital diaphragmatic hernia (CDH) involves lung hypoplasia and pulmonary hypertension (PH). Post-natal Perflubron ventilation induces lung growth. This phenomenon is called Perflubon-induced lung growth (PILG). However, it does not appear to ameliorate PH in CDH. We aim to determine the effect of PILG on pulmonary vascular remodeling in neonates with CDH and PH requiring extracorporeal membrane oxygenation (ECMO).

Methods

Lung tissue from four patients was obtained, three treated with PILG + ECMO, and one maintained on conventional ventilation + ECMO (control). The distribution of collagen was assessed with Masson’s trichrome stain. Immunohistochemistry was done to assess cell proliferation and immunofluorescence to assess vascular morphology.

Results

Comparing PILG vs. control, there was an increase in vessel wall diameter (6.85 μm, 10.28 μm, and 10.35 μm vs. 4.34 μm), increase in collagen thickness in two PILG patients (35.66 μm, 14.23 μm, and 38.46 μm vs. 22.16 μm), and decrease in lumen diameter despite similar total area (48.99 μm, 41.74 μm, and 36.32 μm vs. 51.56 μm) for each PILG patient vs. the control patient, respectively.

Conclusion

PILG does not appear to improve pulmonary vascular remodeling that occurs with PH. The findings are descriptive and will require larger samples to validate the significance of the findings. Overall, further studies will be required to identify the mechanistic causes of PH in CDH to create effective treatments.

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Titel: Effect of Perflubron-induced lung growth on pulmonary vascular remodeling in congenital diaphragmatic hernia
verfasst von: Mansi Shah
Michael R. Phillips
Benjamin Bryner
Ronald B. Hirschl
George B. Mychaliska
Sean E. McLean
Publikationsdatum: 23.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 6/2016
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3887-0

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Effect of Perflubron-induced lung growth on pulmonary vascular remodeling in congenital diaphragmatic hernia