Browsing by Author "Luco Illanes, Matías Fernando"
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- ItemCongenital diaphragmatic hernia defect size and infant morbidity at discharge(2016) Putnam, L.; Harting, M.; Tsao, K.; Morini, F.; Yoder, B.; Luco Illanes, Matías Fernando; Lally, P.; Lally, K.
- ItemCongenital diaphragmatic hernia: phosphodiesterase-5 and Arginase inhibitors prevent pulmonary vascular hypoplasia in rat lungs(2022) Toso, Alberto; Aranguiz, Óscar; Cespedes, Carlos; Navarrete, Orieta; Hernández, Cherie; Vio, Carlos P.; Luco Illanes, Matías Fernando; Casanello Toledo, Paola Cecilia; Kattan Said, Alberto JavierBackground Severe pulmonary hypoplasia related to congenital diaphragmatic hernia (CDH) continues to be a potentially fatal condition despite advanced postnatal management strategies. Objective To evaluate the effect of the antenatal sildenafil and 2(S)-amino-6-boronohexanoic acid (ABH-Arginase inhibitor) on lung volume, pulmonary vascular development, and nitric oxide (NO) synthesis in a Nitrofen-induced CDH rat model. Methods Nitrofen-induced CDH rat model was used. Nitrofen was administrated on embryonic day(E) 9,5. At E14, five intervention groups were treated separately: Nitrofen, Nitrofen+Sildenafil, Nitrofen+ABH, Nitrofen+Sildenafil+ABH and Control. At term, offspring's lungs were weighed, some paraffin-embedded for histology, others snap-frozen to analyze eNOS, Arginase I-II expression, and activity. Results In CDH-bearing offsprings, ABH or Sildenafil+ABH preserved the total lung/body-weight index (p < 0.001), preventing pulmonary vascular smooth muscle cell hyperproliferation and improving lung morphometry. Sildenafil+ABH increased 1.7-fold the lung nitrite levels (p < 0.01) without changes in eNOS expression. Sildenafil and ABH improved the number of pulmonary vessels. Conclusion These results suggest that in this CDH rat model, the basal activity of Arginase participates in the lung volume and, together with phosphodiesterase-5, regulates NOS activity in the term fetal lung. The combined treatment (Sildenafil+ABH) could revert some of the pulmonary features in CDH by improving the local NO synthesis and preventing smooth muscle cell hyperproliferation. Impact This study presents Arginase inhibition as a new therapeutic target and the importance of the combined antenatal treatment to improve pulmonary vascular development in a congenital diaphragmatic hernia (CDH) rat model. This study shows that the action of an Arginase inhibitor (ABH) enhances the effects already described for sildenafil in this model. These results reinforce the importance of prenatal treatments' synergy in recovering the hypoplastic lung in the Nitrofen-induced CDH rat model.
- ItemEarly use of combined exogenous surfactant and inhaled nitric oxide reduces treatment failure in persistent pulmonary hypertension of the newborn : a randomized controlled trial(2020) González, A.; Bancalari, A.; Osorio, W.; Luco Illanes, Matías Fernando; González, A.; Pérez Álvarez, Héctor Iván; Kattan Said, Alberto Javier
- ItemEarly, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia(2021) Munves Ferguson, Dalya; Gupta, Vikas S.; Lally, Pamela A.; Luco Illanes, Matías Fernando; Tsao, KuoJen; Lally, Kevin P.; Patel, Neil; Harting, Matthew T.Introduction: Pulmonary hypertension (PH) is the major pathophysiologic consequence of congenital diaphragmatic hernia (CDH). We aimed to evaluate the association between early CDH-associated PH (CDH-PH) and inpatient outcomes. Methods: The CDH Study Group registry was queried for infants born 2015-2019 with echocardiograms before 48h of life. PH was categorized using echocardiographic findings: none, mild (right ventricular systolic pressure <2/3 systemic), moderate (between 2/3 systemic and systemic), or severe (supra-systemic). Univariate and multivariate analyses were performed. Adjusted Poisson regression was used to assess the primary composite outcome of mortality or oxygen support at 30 days. Results: Of 1,472 patients, 86.5% had CDH-PH: 13.9% mild (n = 193), 44.4% moderate (n = 631), and 33.2% severe (n = 468). On adjusted analysis, the primary outcome of mortality or oxygen support at 30 days occurred more frequently in infants with moderate (incidence rate ratio [IRR] 1.8, 95% confidence interval [CI], 1.2-2.6) and severe CDH-PH (IRR 2.0, 95% CI, 1.3-2.9). Extracorporeal life support (ECLS) utilization was associated only with severe CDH-PH after adjustment (IRR 1.8, 95% CI, 1.0-3.3). Discussion/conclusion: Early, postnatal CDH-PH is independently associated with increased risk for mortality or oxygen support at 30 days and utilization of ECLS. Early echocardiogram is a valuable prognostic tool for early, inpatient outcomes in neonates with CDH.
- ItemEstrategias para reducir infecciones, uso de antimicrobianos y sus efectos en una unidad de neonatología(2017) Urzúa Baquedano, María Soledad; Ferrés Garrido, Marcela Viviana; García Cañete, Patricia; Sánchez, Amparo; Luco Illanes, Matías Fernando
- ItemHypopharyngeal oxygen concentration and pressures delivered by low flow nasal cannula in preterm infants : relationship with flow, gas mixture, and infant's weight(2019) González M., Alvaro; Quinteros, A.; Luco Illanes, Matías Fernando; Salinas, José A.; Martinez, A.; Tapia, J.L.
- ItemPrenatally diagnosed congenital diaphragmatic hernia: optimal mode of delivery?(2017) Burgos, C. M.; Frenckner, B.; Luco Illanes, Matías Fernando; Harting, M. T.; Lally, P. A.; Lally, K. P.
- ItemPrenatally versus postnatally diagnosed congenital diaphragmatic hernia - Side, stage, and outcome(2019) Burgos, C. M.; Frenckner, B.; Luco Illanes, Matías Fernando; Harting, M. T.; Lally, P A.; Lally, K. P.
- ItemRight versus left congenital diaphragmatic hernia - What's the difference?(2018) Mesas Burgos, Carmen; Frenckner, Björn; Luco Illanes, Matías Fernando; Harting, Matthew T.; Lally, Pamela A.; Lally, Kevin P.
- ItemSíndrome de Regresión Caudal. Caso Clínico(2010) Luque H., Maria Jose; Fernández .B, R.; Tuca D., M. J.; Luco Illanes, Matías Fernando; De Barbieri Magnone, Florencia Beatriz; Tapia I., J. L.Antecedentes: El síndrome de regresión caudal es una malformación congénita poco frecuente, caracterizada por un amplio espectro de anormalidades musculoesqueléticas que comprometen columna lumbosacra, pelvis y extremidades inferiores. Se puede asociar a
- ItemVasopressin as adjunctive therapy in pulmonary hypertension associated with refractory systemic hypotension in term newborns(2022) Santelices Ruíz, Felipe; Masoli, Daniela; Kattan Said, Alberto Javier; Toso, Alberto; Luco Illanes, Matías FernandoAbstract Objective. The aim of our study is to describe the effects of vasopressin on term infants with persistent pulmonary hypertension under a standardized protocol. Study Design: In 2019, we designed a standardized protocol for the management of refractory hypotension in the context of pulmonary hypertension, which included the use of vasopressin. This is a retrospective cohort study to evaluate the clinical, laboratory, and echocardiographic outcomes of patients who required vasopressin in the context of this new protocol in a referral level IV neonatal intensive care unit. Results: We included 48 neonates with a median gestational age of 37 weeks in a period of 30 months (December 2019 to May 2022). Congenital diaphragmatic hernia was the main cause of persistent pulmonary hypertension in this cohort (82%). All patients were on mechanical ventilation and receiving inhaled nitric oxide. In our cohort at 4 hours after initiation of vasopressin, blood pressure, serum pH, and urinary output increased significantly. The vasoactive inotropic score, lactate and oxygenation index decreased. Echocardiographic follow-up also showed a decrease in the relative pressure of the right ventricle and an improvement in the cardiac output of both ventricles. There were no episodes of severe hyponatremia (<120 mmol/L). Discussion: This study showed that the use of vasopressin in neonates with persistent pulmonary hypertension and refractory systemic hypotension was associated with a rapid and significant improvement in oxygenation and hemodynamic markers of perfusion, including blood pressure. This association was early during the first hours of treatment and vasopressin was safely withdrawn after a median of 3 days of treatment.
- ItemVentricular dysfunction is a critical determinant of mortality in congenital diaphragmatic hernia(2019) Patel, N.; Lally, P.A.; Kipfmueller, F.; Massolo, A.C.; Luco Illanes, Matías Fernando; Van Meurs, K.P.; Lally, K.P.; Harting, M.T.