{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:41:56Z","timestamp":1765233716336,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["World Jnl Ped Surgery"],"accepted":{"date-parts":[[2023,12,7]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Following on from an earlier study published in 2008 about left pulmonary artery (LPA) flow measured on serial echocardiography being strongly prognostic in left-sided congenital diaphragmatic hernia (CDH) and the ratio of LPA to right pulmonary artery (RPA) diameters being a simple and reliable indicator for commencing nitric oxide (NO) therapy, the ratio of LPA:RPA diameters (PA ratio or PAR) was hypothesized to possibly reflect cardiopulmonary stresses accompanying CDH better.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Subjects with isolated left-sided CDH treated between 2007 and 2020 at a single pediatric surgical center were recruited and classified according to survival. Data obtained retrospectively for subject demographics, clinical course, LPA\/RPA diameters, and PAR were compared between survivors and non-survivors. The value of PAR for optimizing the prognostic value of PA diameter data in CDH were analyzed with receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 65 subjects, there were 54 survivors (82.3%) and 11 non-survivors (17.7%); 7 of 11 non-survivors died before surgical repair could be performed. Mean PAR for survivors (0.851\u00b10.152) was significantly higher than for non-survivors (0.672\u00b10.108) (<jats:italic>p<\/jats:italic>=0.0003). Mean PAR for non-survivors was not affected by surgical repair. Characteristics of survivors were: LPA \u22652\u2009mm (n=52 of 54; mean PAR=0.866\u00b10.146) and RPA \u22653\u2009mm (n=46 of 54; mean PAR=0.857\u00b10.152). Non-survivors with similar LPA and RPA diameters to survivors had significantly lower mean PAR. ROC curve cut-off for PAR was 0.762. Subjects with high PAR (\u22650.762) required high-frequency oscillatory ventilation\/NO less than subjects with low PAR (&lt;0.762) (<jats:italic>p<\/jats:italic>=0.0244\u2009and <jats:italic>p<\/jats:italic>=0.0485, respectively) and subjects with high PAR stabilized significantly earlier than subjects with low PAR (1.71\u00b10.68\u2009days vs 3.20\u00b10.87\u2009days) (<jats:italic>p<\/jats:italic>&lt;0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PAR would appear to be strongly correlated with clinical outcome in CDH and be useful for planning management of cardiopulmonary instability in CDH.<\/jats:p>\n               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A review of 100 cases","volume":"22","author":"Okawada","year":"2006","journal-title":"Pediatr Surg Int"},{"key":"2025081809571714000_7.1.e000686.14","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1159\/000123618","article-title":"Evaluation of normal fetal branch pulmonary artery diameters measured by ultrasonography: a comparison with congenital diaphragmatic hernia","volume":"23","author":"Katayama","year":"2008","journal-title":"Fetal Diagn Ther"},{"key":"2025081809571714000_7.1.e000686.15","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2008.02.004"},{"key":"2025081809571714000_7.1.e000686.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2014.09.008"}],"container-title":["World Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/wjps-2023-000686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T16:57:21Z","timestamp":1755536241000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjps.bmj.com\/lookup\/doi\/10.1136\/wjps-2023-000686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,30]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/wjps-2023-000686"],"URL":"https:\/\/doi.org\/10.1136\/wjps-2023-000686","relation":{},"ISSN":["2516-5410"],"issn-type":[{"type":"electronic","value":"2516-5410"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}