Despite advances in neonatal care, the mortality for congenital diaphragmatic hernia (CDH) remains high. The high mortality in these infants has been attributed to the combination of pulmonary hypoplasia and pulmonary hypertension. The investigators hypothesize that anomalous development of the pulmonary surfactant system may contribute to the impaired lung function in CDH. Moreover the investigators propose that exogenous surfactant therapy (EST), which has been shown to improve pulmonary gas exchange and pulmonary mechanics in surfactant deficient premature infants, might also benefit full term infants with CDH. The overall objective of this study is to characterize the status of the pulmonary surfactant system and to determine the efficacy of EST in the newborn lamb model of CDH. These experiments will determine the efficacy of EST in mitigating the decreased pulmonary gas exchange and abnormal pulmonary mechanics associated with CDH.
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