{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:03:55Z","timestamp":1790643835910,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Congenital Diaphragmatic Hernia (CDH) is a complex disease including a diaphragmatic defect, lung hypoplasia, and pulmonary hypertension. Despite its increasing use in neonates, the literature on the use of vasopressin in neonates is limited. The aim of this work is to analyze the changes in clinical and hemodynamic variables in a cohort of CDH infants treated with vasopressin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among CDH infants managed at the Neonatal Intensive Care Unit (NICU) of our hospital from May 2014 to January 2019, all infants who were treated with vasopressin, because of systemic hypotension and pulmonary hypertension, were enrolled in this retrospective study. The primary outcome was the change in oxygenation index (OI) after the start of the infusion of vasopressin. The secondary outcomes were the changes in cerebral and\u00a0splanchnic fractional tissue oxygen extraction (FTOEc and FTOEs) at near-infrared spectroscopy, to understand the balance between oxygen supply and tissue oxygen consumption after the start of vasopressin infusion. We also reported as secondary outcomes the changes in ratio of arterial oxygen partial pressure (PaO2) to fraction of inspired oxygen (FiO2), heart rate, mean arterial pressure, serum pH, and serum sodium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 27 patients with isolated CDH who received vasopressin administration. OI dramatically dropped when vasopressin infusion started, with a significant reduction according to ANOVA for repeated measures (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). A global significant improvement in FTOEc and FTOEs was detected (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004, respectively) as a significant reduction in heart rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). A global significant improvement in PaO2\/FiO2 ratio was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and also at all time points: at 6\u2005h since infusion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), 12\u2005h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and 24\u2005h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), respectively. A significant reduction in sodium levels was observed as expected side effect (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). No significant changes were observed in the remaining outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data suggest that starting early vasopressin infusion in CDH infants with pulmonary hypertension could improve oxygenation index and near-infrared spectroscopy after 12 and 24\u2005h of infusion. These pilot data represent a background for planning future larger randomized trials to evaluate the efficacy and safety of vasopressin for the CDH population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2023.1104728","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T01:53:35Z","timestamp":1680054815000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Early vasopressin infusion improves oxygenation in infants with congenital diaphragmatic hernia"],"prefix":"10.3389","volume":"11","author":[{"given":"Irma","family":"Capolupo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Umberto","family":"De Rose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mazzeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Monaco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Giliberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Landolfo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Di Pede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Toscano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Conforti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Bagolan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Dotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fped.2017.00195","article-title":"Treatment strategies for congenital diaphragmatic hernia: change sometimes comes bearing gifts","volume":"5","author":"Morini","year":"2017","journal-title":"Front Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.jpeds.2019.12.037","article-title":"Implications of atrial-level shunting by echocardiography in newborns with congenital diaphragmatic hernia","volume":"219","author":"Wehrmann","year":"2020","journal-title":"J Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1055\/s-0040-1712999","article-title":"Effect of vasopressin on systemic and pulmonary hemodynamics in neonates","volume":"38","author":"Budniok","year":"2021","journal-title":"Am J Perinatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/PCC.0b013e31829f5fce","article-title":"Vasopressin as a rescue therapy for refractory pulmonary hypertension in neonates: case series","volume":"15","author":"Mohamed","year":"2014","journal-title":"Pediatr Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1080\/14767058.2020.1757642","article-title":"Vasopressin for refractory persistent pulmonary hypertension of the newborn in preterm neonates\u2013a case series","volume":"35","author":"Mohamed","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jpeds.2014.03.059","article-title":"Vasopressin improves hemodynamic status in infants with congenital diaphragmatic hernia","volume":"165","author":"Acker","year":"2014","journal-title":"J Pediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1159\/000444210","article-title":"Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO consortium consensus - 2015 update","volume":"110","author":"Snoek","year":"2016","journal-title":"Neonatology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3109\/14767058.2011.607673","article-title":"Near infrared spectroscopy in newborns with surgical disease","volume":"24","author":"Giliberti","year":"2011","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.jpeds.2014.10.024","article-title":"Persistence of pulmonary hypertension by echocardiography predicts short-term outcomes in congenital diaphragmatic hernia","volume":"166","author":"Lusk","year":"2015","journal-title":"J Pediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5898","DOI":"10.3390\/ijms21165898","article-title":"Therapeutic drug monitoring is a feasible tool to personalize drug administration in neonates using new techniques: an overview on the pharmacokinetics and pharmacodynamics in neonatal age","volume":"21","author":"De Rose","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"E103","DOI":"10.1503\/cmaj.170206","article-title":"Diagnosis and management of congenital diaphragmatic hernia: a clinical practice guideline","volume":"190","author":"Puligandla","year":"2018","journal-title":"CMAJ"},{"key":"B12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40748-017-0066-9","article-title":"Milrinone in congenital diaphragmatic hernia \u2013 a randomized pilot trial: study protocol, review of literature and survey of current practices","volume":"3","author":"Lakshminrusimha","year":"2017","journal-title":"Matern Health Neonatol Perinatal"},{"key":"B13","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1002\/ppul.25258","article-title":"Pulmonary hypertension is an important co-morbidity in developmental lung diseases of infancy: bronchopulmonary dysplasia and congenital diaphragmatic hernia","volume":"56","author":"Varghese","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jpedsurg.2003.11.010","article-title":"The relationship of pulmonary artery pressure and survival in congenital diaphragmatic hernia","volume":"39","author":"Dillon","year":"2004","journal-title":"J Pediatr Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1164\/rccm.200907-1126OC","article-title":"Congenital diaphragmatic hernia: endothelin-1, pulmonary hypertension, and disease severity","volume":"182","author":"Keller","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s11936-019-0711-x","article-title":"Evaluation and monitoring of pulmonary hypertension in neonates with congenital diaphragmatic hernia","volume":"21","author":"Sanchez Mejia","year":"2019","journal-title":"Curr Treat Opt Cardiovasc Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.clp.2021.11.010","article-title":"Pulmonary vasodilator therapy in persistent pulmonary hypertension of the newborn","volume":"49","author":"Sharma","year":"2022","journal-title":"Clin Perinatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1542\/peds.99.6.838","article-title":"Inhaled nitric oxide and hypoxic respiratory failure in infants with congenital diaphragmatic hernia","volume":"99","year":"1997","journal-title":"Pediatrics"},{"key":"B19","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1056\/NEJM200002173420704","article-title":"Low-dose nitric oxide therapy for persistent pulmonary hypertension of the newborn","volume":"342","author":"Clark","year":"2000","journal-title":"N Engl J Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"CD000399","DOI":"10.1002\/14651858.CD000399.pub3","article-title":"Nitric oxide for respiratory failure in infants born at or near term","volume":"1","author":"Barrington","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fped.2019.00336","article-title":"Extracorporeal membrane oxygenation in congenital diaphragmatic hernia","volume":"7","author":"Rafat","year":"2019","journal-title":"Front Pediatr"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1001\/jamapediatrics.2016.2023","article-title":"Evaluation of variability in inhaled nitric oxide use and pulmonary hypertension in patients with congenital diaphragmatic hernia","volume":"170","author":"Putnam","year":"2016","journal-title":"JAMA Pediatr"},{"key":"B23","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.jpedsurg.2015.07.021","article-title":"Effects\u00a0of ventilation modalities on near-infrared spectroscopy in surgically corrected CDH infants","volume":"51","author":"Conforti","year":"2016","journal-title":"J Pediatr Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.bja.2019.01.014","article-title":"Effects of vasopressin during a pulmonary hypertensive crisis induced by acute hypoxia in a rat model of pulmonary hypertension","volume":"122","author":"Sugawara","year":"2019","journal-title":"Br J Anaesth"},{"key":"B25","doi-asserted-by":"publisher","first-page":"H743","DOI":"10.1152\/ajpheart.1992.262.3.H743","article-title":"Role of nitric oxide in vasopressinergic pulmonary vasodilatation","volume":"262","author":"Russ","year":"1992","journal-title":"Am J Physiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1378\/chest.103.4.1241","article-title":"Arginine vasopressin induces endothelium-dependent vasodilatation of the pulmonary artery. V1-receptor-mediated production of nitric oxide","volume":"103","author":"Evora","year":"1993","journal-title":"Chest"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1210\/endo.140.3.6546","article-title":"Human vascular endothelial cells express oxytocin receptors","volume":"140","author":"Thibonnier","year":"1999","journal-title":"Endocrinology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/cc2338","article-title":"Science review: vasopressin and the cardiovascular system part 2 - clinical physiology","volume":"8","author":"Holmes","year":"2004","journal-title":"Crit Care"},{"key":"B29","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1213\/ANE.0000000000004324","article-title":"Update on congenital diaphragmatic hernia","volume":"131","author":"Chatterjee","year":"2020","journal-title":"Anesth Analg"},{"key":"B30","article-title":"Vasopressina as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns","author":"Santelices","year":""}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1104728\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T01:53:38Z","timestamp":1680054818000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1104728\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,29]]},"references-count":30,"alternative-id":["10.3389\/fped.2023.1104728"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1104728","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,29]]},"article-number":"1104728"}}