Publications by authors named "J Gien"

Introduction: Neonates with congenital diaphragmatic hernia (CDH) who undergo repair while on extracorporeal membrane oxygenation (ECMO) are at risk of developing post-operative bleeding complications. Balanced anticoagulation is critical to maintain ECMO flow and avoid bleeding. Heparin has historically been our first-line anticoagulant; however, recently, we transitioned to bivalirudin, a direct thrombin inhibitor.

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Background: Congenital diaphragmatic hernia (CDH) is characterized by a diaphragmatic defect, leading to herniation of abdominal organs into the chest, lung compression, and impaired lung development, often resulting in pulmonary hypertension and lung hypoplasia. Prenatal imaging techniques like ultrasound and MRI provide anatomical predictors of outcomes, but their limitations necessitate novel biomarkers for better prognostic accuracy.

Objective: This study aims to identify unique circulating maternal, fetal, and neonatal microRNAs (miRNAs) that can distinguish CDH pregnancies from healthy controls and assess their potential as markers of disease severity.

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Article Synopsis
  • The study compares two methods for repairing congenital diaphragmatic hernia (CDH) in patients on ECMO: prosthetic patches and muscle flaps, hypothesizing that flaps would reduce bleeding complications.
  • Analysis showed that the flap technique resulted in significantly lower rates of reoperation for bleeding, reduced blood transfusions post-surgery, and higher survival rates after two years compared to the patch technique.
  • The findings suggest that using muscle flaps during CDH repair on ECMO is associated with fewer complications and better survival outcomes, indicating it may be the preferred approach.
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Introduction: Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality among extremely premature infants. Approximately 50% of cases progress to surgery, frequently resulting in resection of necrotic bowel and ostomy creation. Premature neonates are at risk for bronchopulmonary dysplasia and feeding failure; surgery in these patients is higher risk.

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