Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC)
Resuscitation at birth of infants with Congenital Diaphragmatic Hernia (CDH) remains highly challenging because of severe failure of cardiorespiratory adaptation at birth. Usually, the umbilical cord is clamped immediately after birth. Delaying cord clamping while the resuscitation maneuvers are sta...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-04-01
|
Series: | Children |
Subjects: | |
Online Access: | https://www.mdpi.com/2227-9067/8/5/339 |
id |
doaj-21b3f63b6c46447cbb48502451b7c2ff |
---|---|
record_format |
Article |
spelling |
doaj-21b3f63b6c46447cbb48502451b7c2ff2021-04-26T23:03:20ZengMDPI AGChildren2227-90672021-04-01833933910.3390/children8050339Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC)Kévin Le Duc0Sébastien Mur1Thameur Rakza2Mohamed Riadh Boukhris3Céline Rousset4Pascal Vaast5Nathalie Westlynk6Estelle Aubry7Dyuti Sharma8Laurent Storme9ULR2694 Metrics‑Perinatal Environment and Health, University of Lille, 59000 Lille, FranceDepartment of Neonatology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceDepartment of Neonatology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceDepartment of Neonatology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceDepartment of Neonatology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceDepartment of Obstetrics, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceULR2694 Metrics‑Perinatal Environment and Health, University of Lille, 59000 Lille, FranceULR2694 Metrics‑Perinatal Environment and Health, University of Lille, 59000 Lille, FranceULR2694 Metrics‑Perinatal Environment and Health, University of Lille, 59000 Lille, FranceResuscitation at birth of infants with Congenital Diaphragmatic Hernia (CDH) remains highly challenging because of severe failure of cardiorespiratory adaptation at birth. Usually, the umbilical cord is clamped immediately after birth. Delaying cord clamping while the resuscitation maneuvers are started may: (1) facilitate blood transfer from placenta to baby to augment circulatory blood volume; (2) avoid loss of venous return and decrease in left ventricle filling caused by immediate cord clamping; (3) prevent initial hypoxemia because of sustained uteroplacental gas exchange after birth when the cord is intact. The aim of this trial is to evaluate the efficacy of intact cord resuscitation compared to immediate cord clamping on cardiorespiratory adaptation at birth in infants with isolated CDH. The Congenital Hernia Intact Cord (CHIC) trial is a prospective multicenter open-label randomized controlled trial in two balanced parallel groups. Participants are randomized either immediate cord clamping (the cord will be clamped within the first 15 s after birth) or to intact cord resuscitation group (umbilical cord will be kept intact during the first part of the resuscitation). The primary end-point is the number of infants with APGAR score <4 at 1 min or <7 at 5 min. One hundred eighty participants are expected for this trial. To our knowledge, CHIC is the first study randomized controlled trial evaluating intact cord resuscitation on newborn infant with congenital diaphragmatic hernia. Better cardiorespiratory adaptation is expected when the resuscitation maneuvers are started while the cord is still connected to the placenta.https://www.mdpi.com/2227-9067/8/5/339intact cord resuscitationdelivery room resuscitationcongenital diaphragmatic hernia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kévin Le Duc Sébastien Mur Thameur Rakza Mohamed Riadh Boukhris Céline Rousset Pascal Vaast Nathalie Westlynk Estelle Aubry Dyuti Sharma Laurent Storme |
spellingShingle |
Kévin Le Duc Sébastien Mur Thameur Rakza Mohamed Riadh Boukhris Céline Rousset Pascal Vaast Nathalie Westlynk Estelle Aubry Dyuti Sharma Laurent Storme Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) Children intact cord resuscitation delivery room resuscitation congenital diaphragmatic hernia |
author_facet |
Kévin Le Duc Sébastien Mur Thameur Rakza Mohamed Riadh Boukhris Céline Rousset Pascal Vaast Nathalie Westlynk Estelle Aubry Dyuti Sharma Laurent Storme |
author_sort |
Kévin Le Duc |
title |
Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) |
title_short |
Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) |
title_full |
Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) |
title_fullStr |
Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) |
title_full_unstemmed |
Efficacy of Intact Cord Resuscitation Compared to Immediate Cord Clamping on Cardiorespiratory Adaptation at Birth in Infants with Isolated Congenital Diaphragmatic Hernia (CHIC) |
title_sort |
efficacy of intact cord resuscitation compared to immediate cord clamping on cardiorespiratory adaptation at birth in infants with isolated congenital diaphragmatic hernia (chic) |
publisher |
MDPI AG |
series |
Children |
issn |
2227-9067 |
publishDate |
2021-04-01 |
description |
Resuscitation at birth of infants with Congenital Diaphragmatic Hernia (CDH) remains highly challenging because of severe failure of cardiorespiratory adaptation at birth. Usually, the umbilical cord is clamped immediately after birth. Delaying cord clamping while the resuscitation maneuvers are started may: (1) facilitate blood transfer from placenta to baby to augment circulatory blood volume; (2) avoid loss of venous return and decrease in left ventricle filling caused by immediate cord clamping; (3) prevent initial hypoxemia because of sustained uteroplacental gas exchange after birth when the cord is intact. The aim of this trial is to evaluate the efficacy of intact cord resuscitation compared to immediate cord clamping on cardiorespiratory adaptation at birth in infants with isolated CDH. The Congenital Hernia Intact Cord (CHIC) trial is a prospective multicenter open-label randomized controlled trial in two balanced parallel groups. Participants are randomized either immediate cord clamping (the cord will be clamped within the first 15 s after birth) or to intact cord resuscitation group (umbilical cord will be kept intact during the first part of the resuscitation). The primary end-point is the number of infants with APGAR score <4 at 1 min or <7 at 5 min. One hundred eighty participants are expected for this trial. To our knowledge, CHIC is the first study randomized controlled trial evaluating intact cord resuscitation on newborn infant with congenital diaphragmatic hernia. Better cardiorespiratory adaptation is expected when the resuscitation maneuvers are started while the cord is still connected to the placenta. |
topic |
intact cord resuscitation delivery room resuscitation congenital diaphragmatic hernia |
url |
https://www.mdpi.com/2227-9067/8/5/339 |
work_keys_str_mv |
AT kevinleduc efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT sebastienmur efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT thameurrakza efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT mohamedriadhboukhris efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT celinerousset efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT pascalvaast efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT nathaliewestlynk efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT estelleaubry efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT dyutisharma efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic AT laurentstorme efficacyofintactcordresuscitationcomparedtoimmediatecordclampingoncardiorespiratoryadaptationatbirthininfantswithisolatedcongenitaldiaphragmaticherniachic |
_version_ |
1721507214247591936 |