Evidence map›Paper›PMID 41034644›Full record

ArticlePediatric research2026

Early postnatal echocardiographic characteristics impact survival and extracorporeal life support in congenital diaphragmatic hernia.

Caroline Y Noh, Enrico Danzer, Shazia Bhombal, Valerie Y Chock, Neil Patel, Alex Dahlen, Matthew T Harting, Kevin P Lally, Ashley H Ebanks, Krisa P Van Meurs and 1 more

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
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2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Caroline Y Noh *Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.ORCID https://orcid.org/0000-0002-4462-3811
Enrico Danzer *Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA. edanzer@gmx.de.
Shazia BhombalChildren's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.
Valerie Y ChockDivision of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
Neil PatelRoyal Hospital for Children Glasgow, Glasgow, UK.
Alex DahlenDepartment of Biostatistics, New York University, New York, NY, USA.
Matthew T HartingDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, TX, USA.
Kevin P LallyDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, TX, USA.
Ashley H EbanksDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, TX, USA.
Krisa P Van MeursDivision of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
Congenital Diaphragmatic Hernia Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly echocardiographic characteristics (EC) of congenital diaphragmatic hernia (CDH) neonates and their associations with outcomes, especially differences by laterality and size, are unknown.

methodsCongenital Diaphragmatic Hernia Study Group data between 2015 and 2020 were used. Early postnatal EC, including atrial and ductal shunt direction, pulmonary hypertension (PH) severity, and ventricular size and function, were assessed based on defect laterality and size. Outcomes included mortality and extracoporeal life support (ECLS) use.

resultsThe study population included 1777 infants. Severe PH, right-to-left shunt, left ventricular (LV) hypoplasia, right ventricular dilation, and ventricular dysfunction were more prevalent in larger defects. Independent of defect size, neonates with R-CDH had more severe PH, more bidirectional and right-to-left atrial shunt, and more biventricular (BV) dysfunction. In contrast, L-CDH neonates had more LV hypoplasia and left-to-right atrial shunt. After adjusting for defect side, larger defects were associated with LV hypoplasia and right-to-left and bidirectional atrial shunt. In multivariate analysis, right-to-left atrial shunt and BV dysfunction were associated with increased mortality, whereas bidirectional atrial shunt and BV dysfunction were associated with ECLS use.

conclusionsCDH neonates are at increased risk for early cardiac dysfunction. EC differ by laterality and size. Management of cardiac dysfunction in CDH may improve outcomes. IMPACT: Cardiac dysfunction has emerged as a factor contributing to adverse outcomes in congenital diaphragmatic hernia (CDH). However, there are limited data on the impact of defect size, laterality, and severity of postnatal cardiac dysfunction on outcomes. Echocardiographic characteristics in the first two days of life differ by defect laterality and size. Right-to-left atrial shunt and biventricular dysfunction are associated with increased mortality. Bidirectional atrial shunt and biventricular dysfunction were associated with extracorporeal life support use. Our results support the need for standardized cardiac function assessment in critically ill neonates with CDH. Future strategies to identify and manage these diverse hemodynamic profiles are needed to improve outcomes.

Indexed as

EchocardiographyExtracorporeal Membrane OxygenationHernias, Diaphragmatic, CongenitalFemaleHumansHypertension, PulmonaryInfantInfant, NewbornMaleRetrospective Studies

Identifiers

PMID41034644

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.