The upper airway parameter: the potential prognostic clue for congenital diaphragmatic hernia-a prospective randomized controlled study.

Abstract

PURPOSE: In our previous studies, differences in the upper airway inner diameter between fetuses with thoracic space occupying lesions and normal fetuses were found, but their clinical value has not been further validated. We designed a prospective case-control animal experiment to validate its prognostic value in congenital diaphragmatic hernia (CDH). METHODS: Using Nitrofen to create a fetal SD-rat model of CDH. Calculate the upper airway inner diameter and lung parameters of fetal rats on ultrasonic image and histology sections, and calculate the correlation between the upper airway and lung parameters. Design experiments to rule out the impact of major cardiac malformations on airway development, the correlation between the upper airway inner diameter and the area of CDH was also calculated. RESULTS: There was no significant difference in lung and upper airway parameters between the control group and the group with unsuccessful CDH modeling. The upper airway and lung parameters of fetal rat with CDH were significantly smaller than those without CDH (p&#x2009;<&#x2009;0.01). The correlation between upper airway inner diameter and lung volume is better than that with lung weight, especially the upper airway inner diameter measured on ultrasound images (p&#x2009;<&#x2009;0.01, R&#x2009;=&#x2009;0.76). In the CDH group, the airway lumen diameter was inversely correlated with the hernia area&#xa0;(p = 0.005, R = 0.507). CONCLUSIONS: The upper airway inner diameter of fetal rat was correlated with lung volume, demonstrating the potential predictive value for fetal prognosis of congenital diaphragmatic hernia.