{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:23:26Z","timestamp":1768037006605,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We aimed to explore the postnatal evolution of ventilation\/perfusion ratio (<jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic>) and right-to-left shunt in infants with congenital diaphragmatic hernia (CDH) and whether these indices predicted survival to discharge.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective cohort study at King\u2019s College Hospital, London, UK of infants admitted with CDH in 10 years (2011\u20132021). The non-invasive method of the oxyhaemoglobin dissociation curve was used to determine the <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> and shunt in the first 24\u2009h of life, pre-operation, pre-extubation and in the deceased infants, before death.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eighty-two infants with CDH (71 left-sided) were included with a median (IQR) gestation of 38.1(34.8\u201339.0) weeks. Fifty-three (65%) survived to discharge from neonatal care. The median (IQR) <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> in the first 24\u2009h was lower in the deceased infants [0.09(0.07\u20130.12)] compared to the ones who survived [0.28(0.19\u20130.38), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001]. In the infants who survived, the <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> was lower in the first 24\u2009h [0.28 (0.19\u20130.38)] compared to pre-operation [0.41 (0.3\u20130.49), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001] and lower pre-operation compared to pre-extubation [0.48 (0.39\u20130.55), <jats:italic>p<\/jats:italic>\u2009=\u20090.027]. The shunt was not different in infants who survived compared to the infants who did not.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Ventilation-to-perfusion ratio was lower in infants who died in the neonatal period compared to the ones that survived and improved in surviving infants over the immediate postnatal period.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Impact<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p>The non-invasive method of the oxyhaemoglobin dissociation curve was used to determine the ventilation\/perfusion ratio <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> in infants with congenital diaphragmatic hernia (CDH) in the first 24\u2009h of life, pre-operation, pre-extubation and in the deceased infants, before death.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>The <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> in the first 24\u2009h of life was lower in the infants who did not survive to discharge from neonatal care compared to the ones who survived.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>In the infants who survived, the <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> improved over the immediate postnatal period.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>The non-invasive calculation of <jats:italic>V<\/jats:italic><jats:sub>A<\/jats:sub>\/<jats:italic>Q<\/jats:italic> can provide valuable information relating to survival to discharge.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41390-022-02001-2","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T08:19:43Z","timestamp":1647677983000},"page":"1657-1662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ventilation-to-perfusion relationships and right-to-left shunt during neonatal intensive care in infants with congenital diaphragmatic hernia"],"prefix":"10.1038","volume":"92","author":[{"given":"Theodore","family":"Dassios","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad M.","family":"Shareef Arattu Thodika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Davenport","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kypros H.","family":"Nicolaides","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Greenough","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"key":"2001_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1159\/000480451","volume":"113","author":"KG Snoek","year":"2018","unstructured":"Snoek, K. 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