Pulmonary hypoplasia: An analysis of cases over a 20-year period

array:24 ["pii" => "S2341287916300850" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.022" "estado" => "S300" "fechaPublicacion" => "2016-08-01" "aid" => "1994" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;85:70-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3744 "formatos" => array:3 [ "EPUB" => 136 "HTML" => 2863 "PDF" => 745 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1695403315004051" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2015.10.008" "estado" => "S300" "fechaPublicacion" => "2016-08-01" "aid" => "1994" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;85:70-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 9779 "formatos" => array:3 [ "EPUB" => 156 "HTML" => 8615 "PDF" => 1008 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL" "titulo" => "Hipoplasia pulmonar: análisis de la casuística durante 20 años" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "70" "paginaFinal" => "76" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pulmonary hypoplasia: An analysis of cases over a 20-year period" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1618 "Ancho" => 1586 "Tamanyo" => 74758 ] ] "descripcion" => array:1 [ "es" => "Curva de análisis de supervivencia Kaplan-Meier de los casos diagnosticados de hipoplasia pulmonar." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yanny Paola Delgado-Peña, Alba Torrent-Vernetta, Gabriela Sacoto, Inés de Mir-Messa, Sandra Rovira-Amigo, Silvia Gartner, Antonio Moreno-Galdó, José Andrés Molino-Gahete, Felíx Castillo-Salinas" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Yanny Paola" "apellidos" => "Delgado-Peña" ] 1 => array:2 [ "nombre" => "Alba" "apellidos" => "Torrent-Vernetta" ] 2 => array:2 [ "nombre" => "Gabriela" "apellidos" => "Sacoto" ] 3 => array:2 [ "nombre" => "Inés" "apellidos" => "de Mir-Messa" ] 4 => array:2 [ "nombre" => "Sandra" "apellidos" => "Rovira-Amigo" ] 5 => array:2 [ "nombre" => "Silvia" "apellidos" => "Gartner" ] 6 => array:2 [ "nombre" => "Antonio" "apellidos" => "Moreno-Galdó" ] 7 => array:2 [ "nombre" => "José Andrés" "apellidos" => "Molino-Gahete" ] 8 => array:2 [ "nombre" => "Felíx" "apellidos" => "Castillo-Salinas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287916300850" "doi" => "10.1016/j.anpede.2015.10.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300850?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004051?idApp=UINPBA00005H" "url" => "/16954033/0000008500000002/v1_201607230206/S1695403315004051/v1_201607230206/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341287916300904" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.024" "estado" => "S300" "fechaPublicacion" => "2016-08-01" "aid" => "1997" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;85:77-85" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2956 "formatos" => array:3 [ "EPUB" => 133 "HTML" => 2180 "PDF" => 643 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Catheter tip position and risk of mechanical complications in a neonatal unit" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "77" "paginaFinal" => "85" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Complicaciones mecánicas asociadas a la localización de la punta de catéteres centrales en una unidad neonatal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jose Maria Lloreda-García, Ana Lorente-Nicolás, Francisca Bermejo-Costa, Jose Ramón Fernández-Fructuoso" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Jose Maria" "apellidos" => "Lloreda-García" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Lorente-Nicolás" ] 2 => array:2 [ "nombre" => "Francisca" "apellidos" => "Bermejo-Costa" ] 3 => array:2 [ "nombre" => "Jose Ramón" "apellidos" => "Fernández-Fructuoso" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403315004087" "doi" => "10.1016/j.anpedi.2015.10.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004087?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300904?idApp=UINPBA00005H" "url" => "/23412879/0000008500000002/v1_201607230332/S2341287916300904/v1_201607230332/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2341287915002239" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.07.020" "estado" => "S300" "fechaPublicacion" => "2016-08-01" "aid" => "1986" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;85:61-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2562 "formatos" => array:3 [ "EPUB" => 171 "HTML" => 1909 "PDF" => 482 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Critically ill pediatric hemato-oncology patient: What we do is what we should do?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "61" "paginaFinal" => "69" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Paciente crónico oncohematológico, ¿hacemos lo que deberíamos hacer?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3166 "Ancho" => 2644 "Tamanyo" => 252226 ] ] "descripcion" => array:1 [ "en" => "(a) Do you use HFOV if refractory hypoxemia and/or hypoventilation to conventional mechanical ventilation? (b) Respiratory management if refractory hypoxemia or hypoventilation to conventional mechanical ventilation." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alberto García-Salido, Montserrat Nieto-Moro, María Isabel Iglesias-Bouzas, Marta González-Vicent, Ana Serrano-González, Juan Casado-Flores" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Alberto" "apellidos" => "García-Salido" ] 1 => array:2 [ "nombre" => "Montserrat" "apellidos" => "Nieto-Moro" ] 2 => array:2 [ "nombre" => "María Isabel" "apellidos" => "Iglesias-Bouzas" ] 3 => array:2 [ "nombre" => "Marta" "apellidos" => "González-Vicent" ] 4 => array:2 [ "nombre" => "Ana" "apellidos" => "Serrano-González" ] 5 => array:2 [ "nombre" => "Juan" "apellidos" => "Casado-Flores" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002239?idApp=UINPBA00005H" "url" => "/23412879/0000008500000002/v1_201607230332/S2341287915002239/v1_201607230332/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Pulmonary hypoplasia: An analysis of cases over a 20-year period" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "70" "paginaFinal" => "76" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Yanny Paola Delgado-Peña, Alba Torrent-Vernetta, Gabriela Sacoto, Inés de Mir-Messa, Sandra Rovira-Amigo, Silvia Gartner, Antonio Moreno-Galdó, José Andrés Molino-Gahete, Felíx Castillo-Salinas" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Yanny Paola" "apellidos" => "Delgado-Peña" "email" => array:1 [ 0 => "yannypaola@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alba" "apellidos" => "Torrent-Vernetta" ] 2 => array:2 [ "nombre" => "Gabriela" "apellidos" => "Sacoto" ] 3 => array:2 [ "nombre" => "Inés" "apellidos" => "de Mir-Messa" ] 4 => array:2 [ "nombre" => "Sandra" "apellidos" => "Rovira-Amigo" ] 5 => array:2 [ "nombre" => "Silvia" "apellidos" => "Gartner" ] 6 => array:2 [ "nombre" => "Antonio" "apellidos" => "Moreno-Galdó" ] 7 => array:2 [ "nombre" => "José Andrés" "apellidos" => "Molino-Gahete" ] 8 => array:2 [ "nombre" => "Felíx" "apellidos" => "Castillo-Salinas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital Universitario Vall d¿Hebron, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipoplasia pulmonar: análisis de la casuística durante 20 años" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1618 "Ancho" => 1586 "Tamanyo" => 69792 ] ] "descripcion" => array:1 [ "en" => "Kaplan–Meier survival curve of cases of pulmonary hypoplasia." ] ] ] "textoCompleto" => "IntroductionPulmonary hypoplasia (PH) is a congenital anomaly characterised by impaired growth and development of the lung parenchyma, airways and vessels.<a class="elsevierStyleCrossRefs" href="#bib0205">1–5</a> Its incidence in the general population is of nine to eleven cases per 10,000 live births,<a class="elsevierStyleCrossRefs" href="#bib0210">2,3</a> although this must be an underestimate since infants with lesser degrees of PH survive the neonatal period.<a class="elsevierStyleCrossRef" href="#bib0210">2</a> The prevalence of PH reported in perinatal autopsy case series ranges between 7.8% and 26%,<a class="elsevierStyleCrossRefs" href="#bib0205">1,3</a> and it is the anomaly most frequently associated with perinatal mortality.<a class="elsevierStyleCrossRefs" href="#bib0205">1–6</a>Pulmonary hypoplasia most frequently develops secondary to abnormalities in the thoracic cavity, foetal breathing movements, foetal lung liquid at positive pressure and volume of amniotic fluid.<a class="elsevierStyleCrossRefs" href="#bib0205">1–7</a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises and enumerates the underlying conditions most commonly associated to PH.<a class="elsevierStyleCrossRefs" href="#bib0220">4,8,9</a> The clinical manifestations depend on the degree of lung involvement, ranging from severe bilateral forms to milder unilateral or lobar forms.<a class="elsevierStyleCrossRefs" href="#bib0205">1,10</a> During the neonatal period, it can manifest with respiratory insufficiency, pulmonary hypertension or pulmonary haemorrhage. It characteristically presents with respiratory insufficiency of sudden onset that requires mechanical ventilation with high ventilatory pressures in the absence of atelectasis or obstruction.<a class="elsevierStyleCrossRefs" href="#bib0210">2,11</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The diagnosis can be suspected prenatally based on measurements of lung volume by means of three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI).<a class="elsevierStyleCrossRefs" href="#bib0260">12,13</a> The diagnostic tests used after birth are thoracic computed tomography (CT) and lung scintigraphy, and the diagnosis is confirmed by pathologic examination.<a class="elsevierStyleCrossRefs" href="#bib0205">1–4</a>Different surgical approaches are used prenatally to attenuate the severity of PH in the foetus, such as drainage in cases of hydrothorax or foetoscopic tracheal occlusion (FETO) in severe cases of congenital diaphragmatic hernia.<a class="elsevierStyleCrossRefs" href="#bib0270">14,15</a> After birth, the management of PH consists of supportive measures to guarantee adequate oxygenation during lung growth and development.The established approach to the postnatal management of congenital diaphragmatic hernia is surgical repair followed by the use of invasive ventilatory support techniques with permissive hypercapnia combined with aggressive treatment for pulmonary hypertension.<a class="elsevierStyleCrossRefs" href="#bib0250">10,15–18</a>Recent studies have been pursuing the optimisation of the diagnostic methods, treatments and postnatal care used in patients with PH.<a class="elsevierStyleCrossRef" href="#bib0295">19</a> The aim of our study was to describe the aetiology, diagnostic methods and clinical outcomes of cases of PH diagnosed in a tertiary university hospital.Materials and methodsWe conducted a descriptive retrospective study of patients with PH diagnosed between 1995 and 2014 at the Hospital Universitario Vall d’Hebron de Barcelona that received care in the departments of obstetrics, neonatology, paediatric surgery and paediatric pulmonology.We analysed the following variables: gestational age of the foetus at diagnosis, prenatal ultrasound abnormalities, prenatal surgery, gestational age at birth, age of onset of respiratory symptoms, clinical manifestations, aetiological diagnosis, diagnostic tests used, pathological findings, laterality of lung involvement, duration of required mechanical ventilation and oxygen supplementation, clinical respiratory outcomes (presence or absence of recurrent episodes of wheezing or infection), pulmonary function outcomes, quality of life and survival.We studied the following prenatal surgical interventions: insertion of pleural-amniotic shunts for drainage of amniotic fluid in cases of hydrothorax and FETO in patients with congenital diaphragmatic hernia that met the criteria of being 26 weeks or less of gestational age and with factors associated to high mortality, such as a lung-to-head ratio (LHR) of less than 1 or herniation of the liver into the thoracic cavity.The diagnosis of PH was based on pulmonary perfusion scintigraphy, chest CT and clinical criteria. The criteria for diagnosis were reduced pulmonary perfusion in scintigraphy and reduced volume of the lung and pulmonary vessels of the involved side compared to the contralateral side in CT. The clinical diagnosis was based on the presence of respiratory distress syndrome of the neonate, the need for mechanical ventilation at high pressures and plain chest radiography showing reduced aeration and small lung fields.Lung function was assessed in cooperative children aged more than 5 years by means of forced spirometry, plethysmography and single breath diffusion (DLCO) conforming to the standards set by the European Respiratory Society (ERS). Testing was performed with a Jaeger® spirometer and a Jaeger Masterscreen™ plethysmograph (CareFusion, San Diego, USA). We have expressed the data as z-scores adjusted for sex, age and height based on the reference equations of the Global Lung Initiative (GLI) of 2012 and Rosenthal, respectively.To describe quality of life, we reviewed data from the medical records of yearly check-up visits on factors such as schooling, type of physical activity performed by the child, and limitations in physical activity compared to healthy children of the same age. We analysed survival by means of the Kaplan-Meyer method using SPSS version 21.ResultsWe identified 60 cases, 33 of which corresponded to male patients (55%). There was unilateral involvement in 35 cases (21 left and 15 right) and bilateral involvement in 24 cases. All patients had been assessed before birth by means of 3D ultrasound, and abnormalities had been found in forty-six: oligohydramnios in nineteen, diaphragmatic hernia in twenty-one, hydrothorax in six, Jeune syndrome in two, diaphragmatic eventration in one, and polyhydramnios in one. The mean gestational age at the first abnormal ultrasound was 27 weeks (range, 15–39 weeks). Foetal MRI was performed in seven patients, confirming the presence of congenital diaphragmatic hernia with reduced size of the ipsilateral lung in six patients and arthrogryposis with reduced size of both lungs in one patient.PH was classified as primary in four patients and secondary in fifty-six, and congenital diaphragmatic hernia was the most frequent cause of PH (41%). <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the aetiologies found in our study. The diagnoses associated with the 19 cases of oligohydramnios were renal or urinary tract malformation (6 cases), premature rupture of membranes (5 cases, 3 of which were due to an invasive prenatal intervention), hydrops fetalis (3 cases) and congenital diaphragmatic hernia (1 case), while the aetiology was not established in one case. The mean LHR in patients with congenital diaphragmatic hernia was 0.89 (range, 0.29–4.6). Foetal surgery was performed in fifteen patients following the detection of abnormalities in ultrasound, FETO was performed in eleven cases, and a pleural-amniotic shunt placed in five.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The mean gestational age at birth was 33 weeks (range, 27–39 weeks). Fifty patients had respiratory distress at birth, of whom forty-seven (94%) required mechanical ventilation due to severe hypoxaemia for a mean of nine days. Eight patients had persistent pulmonary hypertension of the newborn.The onset of symptoms occurred later in six patients that received a diagnosis of PH after being assessed for recurrent episodes of bronchitis. The mean chronological age of diagnosis of these six patients was 45 days (range, 30–180). Four patients did not develop any clinically significant respiratory symptoms and received the diagnosis of PH following the detection of dextrocardia in the first year of life, and the presence of scimitar syndrome was subsequently confirmed in all.The diagnosis of PH was suspected in 18 cases of early neonatal death (31%) based on clinical features and compatible plain radiography findings. In 31 cases (51.6%) PH was diagnosed based on chest CT or lung perfusion scintigraphy: both techniques in 14 cases, CT alone in 11 cases, and scintigraphy alone in 6 cases. In patients that underwent scintigraphy, the average perfusion in the affected lung was 29% (range, 8–44%). The diagnosis was confirmed by autopsy in 11 patients (19%).As for mortality, a total of 28 patients (47%) died in the first 60 days post birth, with 25 dying in the perinatal period. Seventy-five percent of the deaths occurred in the first day post birth. Using the Kaplan–Meier method, we estimated that the cumulative probability of death was 25% at 12h post birth and increased to 50% by 60 days post birth (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Four patients were lost to followup, while another 28 were followed up for an average of 5.8 years (range, 0.9–16). Of all the patients that had required ventilatory support in the neonatal period, six went on to require home mechanical ventilation (two of them via tracheostomy) for a median of 36 months, and five required home oxygen therapy for a median of 4 months (range, 2–10 months). One patient developed pulmonary hypertension. Seventeen patients had recurrent respiratory conditions that were classified as pneumonia and recurrent bronchitis, and four developed scoliosis. We analysed the lung function tests performed in the past five years (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Spirometry manoeuvres met the acceptability criteria in 13 out of a total of 28 patients (42.8%; age range, 5–17 years), and plethysmography results were technically adequate in 11 of these 13 children. Five patients had an obstructive pattern (FEV1/FVC<lower limits of normal [LLN]); two had a restrictive pattern (FVC<LLN and FEV1/FVC>LLN and TLC>LLN); and six had a normal pattern, of whom two had air trapping. Three patients had increased airway resistance. Lung diffusion tests were normal in all 11 patients.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Twenty-two patients were able to attend school normally and had a normal exercise tolerance for their age.DiscussionPulmonary hypoplasia results from an arrest in normal lung development due to various factors that are not yet fully understood. We present a detailed review of the patients that received a PH diagnosis in the past 20 years and were managed by an interdisciplinary team at a tertiary care university hospital. We analysed its various causes and clinical presentation, methods used for diagnosis, treatments and outcomes.The aetiological distribution of the cases described in this study is consistent with the data found in the literature,<a class="elsevierStyleCrossRefs" href="#bib0240">8,20,21</a> according to which the most common congenital anomalies associated with PH are diaphragmatic hernia, renal anomalies and skeletal anomalies. We ought to mention other diseases found in our review, such as premature rupture of membranes caused by invasive prenatal procedures such as multifoetal pregnancy reduction or amniocentesis, genetic disorders (trisomy 21), and some that are less understood, such as foetal akinesia/hypokinesia sequence or Pena-Shokeir syndrome (2 cases in our series), characterised by polyhydramnios, intrauterine growth restriction, craniofacial and limb anomalies, arthrogryposis, short umbilical cord, PH, and a very low survival.<a class="elsevierStyleCrossRefs" href="#bib0310">22,23</a> Cases of primary PH are rare and can be unilateral or lobar.<a class="elsevierStyleCrossRef" href="#bib0215">3</a> In our series, only 7.8% of the cases were classified as primary PH.Oligohydramnios was the mechanism associated with PH in one third of the cases in our series. Nimrod et al.<a class="elsevierStyleCrossRef" href="#bib0290">18</a> described a greater impact of premature membrane rupture in foetuses in which rupture occurred before 26 weeks’ gestation and lasted more than five weeks, while Rotschild et al.<a class="elsevierStyleCrossRef" href="#bib0300">20</a> detected pulmonary hypoplasia in up to 14% of foetuses that experienced oligohydramnios following the rupture of membranes before 29 weeks’ gestation.Other authors have analysed the correlation between gestational age and the risk of having PH in association with oligohydramnios, concluding that a duration of oligohydramnios of more than 14 days following the rupture of membranes before 25 weeks’ gestation carries a risk of death due to PH of up to 90%.<a class="elsevierStyleCrossRefs" href="#bib0305">21,22</a> While we did not establish patient subsets in our study to analyse the impact of oligohydramnios based on its duration and gestational age at the time of diagnosis, we found that the mean gestational age at the time oligohydramnios was detected was 27 weeks, which is consistent with the literature.Also consistently with the literature, the congenital malformation most frequently associated with PH was diaphragmatic hernia.<a class="elsevierStyleCrossRefs" href="#bib0250">10,24,25</a> This disease is the model that has been used most commonly for the study of early interventions, the pathophysiology, advances in perinatal care and the development of new diagnostic tools in PH.<a class="elsevierStyleCrossRef" href="#bib0330">26</a> A distinctive aspect of congenital diaphragmatic hernia is that PH develops as an inherent feature of the disease and not solely as a result of lung compression, and the mechanism by which the lung contralateral to the hernia is also affected remains unknown.<a class="elsevierStyleCrossRefs" href="#bib0285">17,18</a>The prenatal diagnosis of PH and its confirmation in the early neonatal period are key in decreasing the morbidity and mortality associated to this disease. Consequently, the routine use of 3D ultrasound and MRI for prenatal diagnosis has become a care standard.<a class="elsevierStyleCrossRefs" href="#bib0265">13,16,27,28</a> The current ERS guidelines for the management of congenital diaphragmatic hernia include the use of MRI for the prenatal assessment of affected foetuses, as it performs better than ultrasound in detecting herniation of the liver into the thorax, differentiating diaphragmatic eventrations and accurate volumetry of both the contralateral and ipsilateral lungs.<a class="elsevierStyleCrossRef" href="#bib0345">29</a> Levine et al.<a class="elsevierStyleCrossRef" href="#bib0335">27</a> performed MRI scans on 74 foetuses in whom ultrasound had detected thoracic abnormalities, confirming that the use of a complementary noninvasive technique contributed additional information in up to 38% of cases and led to changes in the management of 8% of them. All our patients were assessed by prenatal 3D ultrasound, and patients with severe diaphragmatic hernia were also assessed by MRI.Of the 24 patients in whom congenital diaphragmatic hernia was diagnosed as the cause of PH, 11 were classified as being at high risk of dying and met the criteria for prenatal surgery, so they underwent FETO. Invasive prenatal surgical procedures have evolved from open surgery with placement of a tracheal clip to the FETO technique in which, after ascertaining lung growth, the balloon is removed prenatally. These techniques have led to an increase in postnatal survival and a decrease in the incidence of secondary pulmonary hypertension.<a class="elsevierStyleCrossRefs" href="#bib0275">15,30,31</a>After birth, PH may be suspected when plain radiography findings include diaphragmatic domes elevated up to the seventh rib, a bell-shaped thorax, downward sloping ribs, pneumothorax or pneumomediastinum.<a class="elsevierStyleCrossRefs" href="#bib0210">2,3,32</a> Pulmonary perfusion scintigraphy and chest computed tomography are very useful in confirming the diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0225">5,32–37</a> In our series, 50.4% of the cases were diagnosed by scintigraphy and CT, 31% by plain radiography and compatible clinical features (cases that could not be confirmed by means of other techniques due to the early death of the patients), and 19% by autopsy. The average measurement of perfusion by scintigraphy is used to determine the severity of PH, which is considered moderate if perfusion in the involved lung is less than 40%.<a class="elsevierStyleCrossRefs" href="#bib0365">33–35</a>The perinatal mortality observed in our series was 41.6%, which was consistent with the various series published in the literature that have described a high perinatal mortality.<a class="elsevierStyleCrossRefs" href="#bib0210">2,4,10,15,25</a> When we analysed our data, we found that the cumulative probability of dying in the first 12h post birth was 25%, and that this probability rose to 50% by 60 days post birth, a finding that underscored the need to have a highly specialised interdisciplinary team for the management of these patients during the early neonatal period. The clinical manifestations observed most frequently during followup were pneumonia and recurrent bronchitis, consistent with the course of disease described in patients that have undergone surgical repair of congenital diaphragmatic hernia and cases of late onset with similar symptoms.<a class="elsevierStyleCrossRefs" href="#bib0345">29,37</a> Twenty-five percent of the patients that required mechanical ventilation in the neonatal period and survived required home mechanical ventilation and oxygen supplementation for a median of four months. These data differ from the current literature, which describes a shorter duration of respiratory support.<a class="elsevierStyleCrossRef" href="#bib0370">34</a> This could be due to a lack of descriptive studies similar to the one we have performed in our population. On the other hand, 16% of our patients developed scoliosis secondary to the unilateral reduction in lung volume. Previous studies have shown that up to 16% of children with a previous history of diaphragmatic hernia have some type of thoracic asymmetry, such as scoliosis or pectus carinatum.<a class="elsevierStyleCrossRef" href="#bib0370">34</a> Other longitudinal studies in children that had undergone surgical repair of diaphragmatic hernia showed catch-up lung growth and adequate exercise tolerance, with children being able to lead normal lives despite the persistence of asymmetry in radiological images and a lack of changes in perfusion scans.<a class="elsevierStyleCrossRef" href="#bib0295">19</a> Our study showed similar results, as 77% of the patients that survived in our series could attend school normally and had an adequate exercise tolerance for their age.When it comes to lung function tests, some authors have described an obstructive airway pattern in patients with HP and proposed that bronchoscopy be performed to rule out tracheobronchomalacia.<a class="elsevierStyleCrossRef" href="#bib0390">38</a> Most studies have reported a predominance of restrictive airway patterns, especially in patients requiring prolonged mechanical ventilation or oxygen therapy.<a class="elsevierStyleCrossRefs" href="#bib0395">39,40</a> In our case series, few data on lung function were available because we only took into account the data collected in the past five years, during which lung function testing was performed by the same technicians with the same equipment and adhering to the stringent quality and acceptability criteria published by the ERS, to avoid potential biases. Furthermore, most of the patients in followup could not cooperate with spirometry or plethysmography. Thus far, our results have shown a higher proportion of children in followup with an obstructive pattern compared to a restrictive pattern based on spirometry as well as plethysmography.In the past two decades, there have been advances in the diagnostic techniques and prenatal interventions for PH, and postnatal care for this disease has been optimised. This has led to the improved management of these patients, although the associated morbidity and mortality continue to be considerable. We believe that further studies are required to assess the impact of these early interventions on future lung development. Furthermore, we must continue to do research to identify other factors that would allow changing the course of PH earlier and by less invasive methods.ConclusionsPH is a congenital anomaly that can be due to various causes and the prevalence of which is underestimated. It is associated with a high neonatal mortality and significant long-term morbidity, which calls for early diagnosis and intervention by a specialised interdisciplinary team. The development of new diagnostic and surgical techniques has improved survival in these patients, but further research is necessary to identify new factors that would allow changing the course of this disease, along with long-term studies to assess the impact of these interventions.Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres698461" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec708214" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres698462" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec708215" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-08-31" "fechaAceptado" => "2015-10-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec708214" "palabras" => array:3 [ 0 => "Pulmonary hypoplasia" 1 => "Pulmonary agenesis" 2 => "Congenital diaphragmatic hernia" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec708215" "palabras" => array:3 [ 0 => "Hipoplasia pulmonar" 1 => "Agenesia pulmonar" 2 => "Hernia diafragmática congénita" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionPulmonary hypoplasia is the most frequent congenital anomaly associated with perinatal mortality. Material and methodsA retrospective and descriptive review was conducted on cases of patients diagnosed with pulmonary hypoplasia between 1995 and 2014 in a tertiary university hospital. An analysis was made of the prenatal imaging, clinical manifestations, post-natal diagnostic tests, treatment and management, long-term follow up, and survival data. ResultsA total of 60 cases were identified, all of them with prenatal imaging. Sixteen patients required foetal surgery. Congenital diaphragmatic hernia was the most frequent diagnosis. Main clinical presentation was respiratory distress with severe hypoxaemia and high requirements of mechanical ventilation. Mortality rate was 47% within first 60 days of life, and 75% for the first day of life. Pneumonia and recurrent bronchitis episodes were observed during follow-up. They had a lung function obstructive pattern, and their quality of life and exercise tolerance was good. ConclusionsHigh neonatal mortality and significant long-term morbidity associated with pulmonary hypoplasia requires an early diagnosis and a specialised multidisciplinary team management." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa hipoplasia pulmonar es la anomalía congénita más frecuentemente asociada a mortalidad perinatal. Material y métodosSe ha realizado un estudio descriptivo retrospectivo de los casos de hipoplasia pulmonar diagnosticados entre 1995 y 2014 en un hospital universitario de tercer nivel, analizando estudios prenatales, manifestaciones clínicas, pruebas diagnósticas, tratamiento, datos de seguimiento a largo plazo y supervivencia. ResultadosSe identificaron 60 casos, todos con estudio prenatal. Dieciséis recibieron intervención quirúrgica intraútero. La hernia diafragmática congénita fue la entidad más frecuentemente asociada. La manifestación clínica más habitual fue distrés respiratorio neonatal, hipoxemia grave y necesidad de soporte con ventilación mecánica. Se halló un 47% de mortalidad antes de los 60 días de vida y del 75% en las primeras 24 h de vida. Durante el seguimiento de los supervivientes se detectaron episodios de neumonías y bronquitis recidivantes, función pulmonar con patrón obstructivo y aceptable calidad de vida y tolerancia al ejercicio. ConclusionesLa elevada mortalidad neonatal y la importante morbilidad a largo plazo de la hipoplasia pulmonar requieren de un diagnóstico temprano y la intervención de un equipo multidisciplinar especializado." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Delgado-Peña YP, Torrent-Vernetta A, Sacoto G, de Mir-Messa I, Rovira-Amigo S, Gartner S, et al. Hipoplasia pulmonar: análisis de la casuística durante 20 años. An Pediatr (Barc). 2016;85:70–76." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1618 "Ancho" => 1586 "Tamanyo" => 69792 ] ] "descripcion" => array:1 [ "en" => "Kaplan–Meier survival curve of cases of pulmonary hypoplasia." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities of the thoracic cavity \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities in foetal lung fluid flow \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities in foetal breathing movements \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Space-occupying lesions in the chest Congenital diaphragmatic hernia Malformation of the airways (such as cystic adenomatoid malformation) Pleural effusion Exomphalos Gastroschisis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="4" align="left" valign="top">Hypoplastic left or right heart Pulmonary stenosis Oligohydramnios Renal agenesis Cystic dysplasia Urinary outflow obstruction Prolonged rupture of membranes Hydrops fetalis</td><td class="td" title="table-entry " rowspan="4" align="left" valign="top">Neuromuscular disorders Neurological problems Pena-Shokeir syndrome</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chest wall malformations \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kyphoscoliosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Skeletal dysplasias \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1144692.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Classification of the underlying conditions that may cause secondary pulmonary hypoplasia." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Causes of pulmonary hypoplasia \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number of cases (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased patients \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients that required mechanical ventilation in the neonatal period \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients that received home mechanical ventilation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diaphragmatic hernia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Left \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Right \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diaphragmatic paralysis-eventration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Renal/urinary tract malformation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Invasive prenatal intervention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hydrops fetalis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Premature rupture of membranes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oligohydramnios of unknown aetiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Congenital hydrothorax \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jeune syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Scimitar syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (8,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intrathoracic masses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unknown aetiology (associated with Down syndrome) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1,6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal akinesia/hypokinesia sequence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary pulmonary hypoplasia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (6,6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1144693.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of aetiologies and outcomes of cases of pulmonary hypoplasia diagnosed between 1995 and 2014." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FVC z-score<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FEV1 z-score<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FEV1/FVC z-score \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TLC z-score<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Interpretation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstructive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–3.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstructive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Restrictive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–3.43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstructive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–3.92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–3.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstructive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Restrictive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstructive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median z-score (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.06 (–2.84 to 1.18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–2.55 (–3.92 to 0.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–1 (–3.12 to 0.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">–0.25 (–1.88 to 1.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1144694.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "z-score: Global Lung Function reference equations (GLI)." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "z-score: total lung capacity (TLC) plethysmography using the Rosenthal reference equations." ] ] ] "descripcion" => array:1 [ "en" => "Results of the analysis of lung function tests performed in the past five years in children with pulmonary hypoplasia diagnosed between 1995 and 2014 at the Hospital Universitario Vall d’Hebron de Barcelona." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0205" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary hypoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Porter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/fn.81.2.F81" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "1999" "volumen" => "81" "paginaInicial" => "F81" "paginaFinal" => "F83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10448173" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0210" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The fetal lung 2: pulmonary hypoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.A. Laudy" 1 => "J.M. Wladimiroff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1469-0705.2000.00252.x" "Revista" => array:7 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2000" "volumen" => "16" "paginaInicial" => "482" "paginaFinal" => "494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11169336" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1552526016302448" "estado" => "S300" "issn" => "15525260" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0215" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary unilateral pulmonary hypoplasia: neonate through early childhood: case report, radiographic diagnosis and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.E. Abrams" 1 => "V.L. Ackerman" 2 => "W.A. Engle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.jp.7211156" "Revista" => array:6 [ "tituloSerie" => "J Perinatol" "fecha" => "2004" "volumen" => "24" "paginaInicial" => "667" "paginaFinal" => "670" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15454946" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0220" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary hypoplasia with hepatic and renal anomalies in a dead fetus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Ravindrakumar" 1 => "V.S. Devi" 2 => "U.U. Rani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0970-2113.95329" "Revista" => array:6 [ "tituloSerie" => "Lung India" "fecha" => "2012" "volumen" => "29" "paginaInicial" => "163" "paginaFinal" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22628933" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0225" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hipoplasia pulmonar infantil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Tortajada Girbés" 1 => "A. Clement Paredes" 2 => "E. García Muñoz" 3 => "M. Gracia Antequera" 4 => "F. Delgado Cordón" 5 => "E. Hernández Marc" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2007" "volumen" => "67" "paginaInicial" => "78" "paginaFinal" => "79" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0230" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unilateral pulmonary agenesis, aplasia and dysplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Dembinski" 1 => "M. Kroll" 2 => "M. Lewin" 3 => "P.Z. Winkler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Geburtshilfe Neonatol" "fecha" => "2009" "volumen" => "213" "paginaInicial" => "56" "paginaFinal" => "61" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0235" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hereditary renal adysplasia, pulmonary hypoplasia and Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Acién" 1 => "F. Galán" 2 => "I. Manchón" 3 => "E. Ruiz" 4 => "M. Acién" 5 => "L. Alcaraz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1750-1172-5-6" "Revista" => array:5 [ "tituloSerie" => "Orphanet J Rare Dis" "fecha" => "2010" "volumen" => "5" "paginaInicial" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20388228" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0240" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human pulmonary hypoplasia: statistical, morphological, morphometric, and biochemical study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Nakamura" 1 => "K. Harada" 2 => "I. Yamamoto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "1992" "volumen" => "116" "paginaInicial" => "635" "paginaFinal" => "642" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1616425" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0245" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary hypoplasia-diaphragmatic hernia-anophthalmia-cardiac defect (PDAC) sindrome due to STRA6 mutations—what are the minimal criteria?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Segel" 1 => "E. Levy-Lahad" 2 => "F. Pasutto" 3 => "E. Picard" 4 => "A. Rauch" 5 => "G. Alterescu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajmg.a.33038" "Revista" => array:7 [ "tituloSerie" => "Am J Med Genet Part A" "fecha" => "2009" "volumen" => "149A" "paginaInicial" => "2457" "paginaFinal" => "2463" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19839040" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314014156" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0250" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malformaciones congénitas de las vías respiratorias inferiores" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Martín" 1 => "M. Benavides" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Pediatr Integral" "fecha" => "2012" "volumen" => "16" "paginaInicial" => "62" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0255" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Apoyo ventilatorio domiciliario en niños con insuficiencia respiratoria crónica: experiencia clínica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Sánchez" 1 => "A. Valenzuela" 2 => "P. Bertrand" 3 => "C. Alvarez" 4 => "N. Holmgren" 5 => "S. Vilches" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Chil Pediatr" "fecha" => "2002" "volumen" => "73" "paginaInicial" => "51" "paginaFinal" => "55" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0260" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital diaphragmatic hernia: predictive value of MRI relative lung-to-head ratio compared with MRI fetal lung volume and sonographic lung-to-head ratio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.K. Kilian" 1 => "T. Schaible" 2 => "V. Hofmann" 3 => "J. Brade" 4 => "K.W. Neff" 5 => "K.A. Büsing" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.08.1082" "Revista" => array:6 [ "tituloSerie" => "AJR" "fecha" => "2009" "volumen" => "192" "paginaInicial" => "153" "paginaFinal" => "158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19098195" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0265" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicting neonatal deaths and pulmonary hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume-body weight ratio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Ruano" 1 => "M. Aubry" 2 => "Y. Dumez" 3 => "M. Zugaib" 4 => "A. Benachi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.07.3078" "Revista" => array:7 [ "tituloSerie" => "AJR" "fecha" => "2008" "volumen" => "190" "paginaInicial" => "1216" "paginaFinal" => "1219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18430834" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314020828" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0270" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The outcome of isolated primary fetal hydrothorax: a 10 year review from a tertiary center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Petersen" 1 => "R. Kaur" 2 => "J.T. Thomas" 3 => "R. Cincotta" 4 => "G. Gardener" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000351855" "Revista" => array:6 [ "tituloSerie" => "Fetal Diagn Ther" "fecha" => "2013" "volumen" => "34" "paginaInicial" => "69" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23817182" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0275" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento intrauterino de la hernia diafragmática congénita grave mediante oclusión traqueal fetoscópica. Protocolo europeo de colaboración" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Peiró" 1 => "E. Gratacós" 2 => "J. Carreras" 3 => "J. LLoret" 4 => "N. Toran" 5 => "S. Salcedo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Cir Infantil" "fecha" => "2005" "volumen" => "15" "paginaInicial" => "28" "paginaFinal" => "33" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0280" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital diaphragmatic hernia: where and what is the evidence?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.D. Losty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Semin Pediatr Surg" "fecha" => "2014" "volumen" => "23" "paginaInicial" => "78" "paginaFinal" => "82" "itemHostRev" => array:3 [ "pii" => "S0167527314020257" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0285" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary development considerations in the surgical management of congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Kholdebarin" 1 => "B. Iwasiow" 2 => "R. Keijzer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.earlhumdev.2011.08.017" "Revista" => array:6 [ "tituloSerie" => "Early Hum Dev" "fecha" => "2011" "volumen" => "87" "paginaInicial" => "755" "paginaFinal" => "758" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21920679" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0290" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of very prolonged membrane rupture on fetal development" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Nimrod" 1 => "F. Varela-gittings" 2 => "G. Machin" 3 => "D. Campbell" 4 => "R. Wesemberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "1984" "volumen" => "148" "paginaInicial" => "540" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6702914" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314016593" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0295" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow-up of patients with high risk congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Kamata" 1 => "N. Usui" 2 => "M. Kamiyama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2005.08.022" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2005" "volumen" => "40" "paginaInicial" => "1833" "paginaFinal" => "1838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16338300" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0300" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neonatal outcome after prolonged preterm rupture of membranes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Rostschild" 1 => "E.W. Ling" 2 => "M. Puterman" 3 => "D. Farquharson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "1990" "volumen" => "162" "paginaInicial" => "46" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2301516" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0305" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preterm premature rupture of the membranes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Mercer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "2003" "volumen" => "101" "paginaInicial" => "178" "paginaFinal" => "193" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12517665" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0310" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secuencia de hipokinesia fetal (fenotipo de Pena Shokeir tipo I). Sobrevida y calidad de vida. Enfoque multidisciplinario" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Rossato" 1 => "G. Fernandez" 2 => "K. Ja" 3 => "R. Sod" 4 => "M. Busso" 5 => "L. di Lillo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Argent Pediatr" "fecha" => "2005" "volumen" => "103" "paginaInicial" => "430" "paginaFinal" => "434" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0315" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of pulmonary artery agenesis and hypoplasia of the lung" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Vitiello" 1 => "C. Pisanti" 2 => "A. Pisanti" 3 => "M. Silberbach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ppul.20421" "Revista" => array:7 [ "tituloSerie" => "Pediatr Pulmonol" "fecha" => "2006" "volumen" => "41" "paginaInicial" => "897" "paginaFinal" => "899" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16850441" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314018154" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0320" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric chest I: developmental and physiologic conditions for the surgeon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Guidry" 1 => "E. McGahren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.suc.2012.03.013" "Revista" => array:7 [ "tituloSerie" => "Surg Clin N Am" "fecha" => "2012" "volumen" => "92" "paginaInicial" => "615" "paginaFinal" => "643" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22595712" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0890856713001937" "estado" => "S300" "issn" => "08908567" ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0325" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital diaphragmatic hernia—mechanisms of pulmonary hipoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Labbé" 1 => "K. Coste" 2 => "P.J. Déchelotte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmr.2010.10.032" "Revista" => array:6 [ "tituloSerie" => "Rev Mal Respir" "fecha" => "2011" "volumen" => "28" "paginaInicial" => "463" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21549902" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0330" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "RM fetal: patología torácica y abdomino-pélvica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Recio" 1 => "P. Martínez" 2 => "J. Pérez" 3 => "C. Bermejo" 4 => "I. Tamarit" 5 => "I. Pastor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Argent Radiol" "fecha" => "2012" "volumen" => "76" "paginaInicial" => "1" "paginaFinal" => "28" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0335" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal thoracic abnormalities: MR imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Levine" 1 => "C.E. Barnewolt" 2 => "T.S. Mehta" 3 => "I. Trop" 4 => "J. Estroff" 5 => "G. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2282020604" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2003" "volumen" => "228" "paginaInicial" => "379" "paginaFinal" => "388" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12821772" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0340" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal MRI-calculated total lung volumes in the prediction of short-term outcome in giant omphalocele: preliminary findings" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Danzer" 1 => "T. Victoria" 2 => "M. Bebbington" 3 => "J. Siegle" 4 => "N. Rintoul" 5 => "M. Johnson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000334284" "Revista" => array:6 [ "tituloSerie" => "Fetal Diagn Ther" "fecha" => "2012" "volumen" => "31" "paginaInicial" => "248" "paginaFinal" => "253" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22572017" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0345" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital diaphragmatic hernia. ERS Task force report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Kotecha" 1 => "A. Barbato" 2 => "A. Bush" 3 => "F. Claus" 4 => "M. Davenport" 5 => "C. Delacourt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00066511" "Revista" => array:7 [ "tituloSerie" => "Eur Respir J" "fecha" => "2012" "volumen" => "39" "paginaInicial" => "820" "paginaFinal" => "829" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22034651" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1552526016302448" "estado" => "S300" "issn" => "15525260" ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0350" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Innovations in the surgical management of congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Tsao" 1 => "K. Lally" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clp.2012.04.002" "Revista" => array:7 [ "tituloSerie" => "Clin Perinatol" "fecha" => "2012" "volumen" => "39" "paginaInicial" => "363" "paginaFinal" => "374" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22682385" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314021111" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0355" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early fetoscopic tracheal occlusion for extremely severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia: preliminary results" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Ruano" 1 => "J. Peiró" 2 => "M. Silvas" 3 => "J. Campos" 4 => "E. Carreras" 5 => "U. Tannuris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.12414" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2013" "volumen" => "42" "paginaInicial" => "70" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23349059" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0360" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hipoplasia pulmonar: causa de errores diagnósticos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Salcedo" 1 => "A. Rodriguez" 2 => "A. de la Huerga" 3 => "I. Marsiinyach" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Pediatr Esp" "fecha" => "2006" "volumen" => "64" "paginaInicial" => "260" "paginaFinal" => "268" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0365" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mid- and long-term effects on pulmonary perfusión, anatomy and diaphragmatic motility in survivors of congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Arena" 1 => "S. Baldari" 2 => "A. Centorrino" 3 => "M. Calabró" 4 => "G. Pajino" 5 => "S. Arena" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00383-005-1557-8" "Revista" => array:6 [ "tituloSerie" => "Pediatr Surg Int" "fecha" => "2005" "volumen" => "21" "paginaInicial" => "954" "paginaFinal" => "959" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16240135" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0370" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary morbidity in 100 survivors of congenital diaphragmatic hernia monitored in a multidisciplinary clinic" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.S. Muratore" 1 => "V. Kharasch" 2 => "D.P. Lund" 3 => "C. Sheils" 4 => "S. Friedman" 5 => "C. Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/jpsu.2001.20031" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2001" "volumen" => "36" "paginaInicial" => "133" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11150452" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0375" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for lung scintigraphy in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Ciofeta" 1 => "A. Piepsz" 2 => "I. Roca" 3 => "S. Fisher" 4 => "K. Hahn" 5 => "R. Sixt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-007-0485-3" "Revista" => array:7 [ "tituloSerie" => "Eur J Nucl Med Mol Imaging" "fecha" => "2007" "volumen" => "34" "paginaInicial" => "1518" "paginaFinal" => "1526" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17602223" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527314007050" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0380" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital anomalies of the tracheobronchial tree, lung and mediastinum: embryology, radiology and pathology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Berrocal" 1 => "C. Madrid" 2 => "S. Novo" 3 => "J. Gutierrez" 4 => "A. Arjonilla" 5 => "N. Gómez-León" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.e17" "Revista" => array:5 [ "tituloSerie" => "Radiographics" "fecha" => "2004" "volumen" => "24" "paginaInicial" => "e17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14610245" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0385" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hipoplasia pulmonary en el adulto" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.A. Carmona-Ruiz" 1 => "M. Lamothe-Ibarra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Int Mex" "fecha" => "2014" "volumen" => "30" "paginaInicial" => "348" "paginaFinal" => "351" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0390" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Right-sided pulmonary aplasia: longitudinal lung function studies in two cases and comparison to results from healthy term neonates" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Nowotny" 1 => "B. Ahrens" 2 => "K. Bittigau" 3 => "S. Buttenberg" 4 => "H. Hammer" 5 => "K. Kalache" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Pediatr Pulmonol" "fecha" => "1998" "volumen" => "26" "paginaInicial" => "138" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9727767" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0920996413006610" "estado" => "S300" "issn" => "09209964" ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0395" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective longitudinal evaluation of lung function during first year of life after repair of congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Spoel" 1 => "L. ven den Hout" 2 => "S.J. Gischler" 3 => "W. Hop" 4 => "I. Reiss" 5 => "D. Tibboel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PCC.0b013e3182231872" "Revista" => array:5 [ "tituloSerie" => "Paediatr Crit Care" "fecha" => "2012" "volumen" => "13" "paginaInicial" => "e133-9" "itemHostRev" => array:3 [ "pii" => "S0022395613001556" "estado" => "S300" "issn" => "00223956" ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0400" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of early lung function in patients with congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Wright" 1 => "A. Filbrun" 2 => "B. Bryner" 3 => "G. Mychaliska" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/jpedsurg.2014.01.016" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2014" "volumen" => "49" "paginaInicial" => "882" "paginaFinal" => "885" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24888827" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008500000002/v1_201607230332/S2341287916300850/v1_201607230332/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008500000002/v1_201607230332/S2341287916300850/v1_201607230332/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300850?idApp=UINPBA00005H"]

Statistics

Original Article

Pulmonary hypoplasia: An analysis of cases over a 20-year period

Hipoplasia pulmonar: análisis de la casuística durante 20 años

Yanny Paola Delgado-Peña

Corresponding author

yannypaola@yahoo.es

Corresponding author.

, Alba Torrent-Vernetta, Gabriela Sacoto, Inés de Mir-Messa, Sandra Rovira-Amigo, Silvia Gartner, Antonio Moreno-Galdó, José Andrés Molino-Gahete, Felíx Castillo-Salinas

Hospital Universitario Vall d¿Hebron, Barcelona, Spain

Read

13105

Times
was read the article

3248

Total PDF

9857

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341287916300850"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2015.10.022"
  "estado" => "S300"
  "fechaPublicacion" => "2016-08-01"
  "aid" => "1994"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2016;85:70-6"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3744
    "formatos" => array:3 [
      "EPUB" => 136
      "HTML" => 2863
      "PDF" => 745
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1695403315004051"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2015.10.008"
      "estado" => "S300"
      "fechaPublicacion" => "2016-08-01"
      "aid" => "1994"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2016;85:70-6"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 9779
        "formatos" => array:3 [
          "EPUB" => 156
          "HTML" => 8615
          "PDF" => 1008
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Hipoplasia pulmonar&#58; an&#225;lisis de la casu&#237;stica durante 20 a&#241;os"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "70"
            "paginaFinal" => "76"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Pulmonary hypoplasia&#58; An analysis of cases over a 20-year period"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1618
                "Ancho" => 1586
                "Tamanyo" => 74758
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curva de an&#225;lisis de supervivencia Kaplan-Meier de los casos diagnosticados de hipoplasia pulmonar&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Yanny Paola Delgado-Pe&#241;a, Alba Torrent-Vernetta, Gabriela Sacoto, In&#233;s de Mir-Messa, Sandra Rovira-Amigo, Silvia Gartner, Antonio Moreno-Gald&#243;, Jos&#233; Andr&#233;s Molino-Gahete, Fel&#237;x Castillo-Salinas"
            "autores" => array:9 [
              0 => array:2 [
                "nombre" => "Yanny Paola"
                "apellidos" => "Delgado-Pe&#241;a"
              ]
              1 => array:2 [
                "nombre" => "Alba"
                "apellidos" => "Torrent-Vernetta"
              ]
              2 => array:2 [
                "nombre" => "Gabriela"
                "apellidos" => "Sacoto"
              ]
              3 => array:2 [
                "nombre" => "In&#233;s"
                "apellidos" => "de Mir-Messa"
              ]
              4 => array:2 [
                "nombre" => "Sandra"
                "apellidos" => "Rovira-Amigo"
              ]
              5 => array:2 [
                "nombre" => "Silvia"
                "apellidos" => "Gartner"
              ]
              6 => array:2 [
                "nombre" => "Antonio"
                "apellidos" => "Moreno-Gald&#243;"
              ]
              7 => array:2 [
                "nombre" => "Jos&#233; Andr&#233;s"
                "apellidos" => "Molino-Gahete"
              ]
              8 => array:2 [
                "nombre" => "Fel&#237;x"
                "apellidos" => "Castillo-Salinas"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287916300850"
          "doi" => "10.1016/j.anpede.2015.10.022"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300850?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004051?idApp=UINPBA00005H"
      "url" => "/16954033/0000008500000002/v1_201607230206/S1695403315004051/v1_201607230206/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287916300904"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.10.024"
    "estado" => "S300"
    "fechaPublicacion" => "2016-08-01"
    "aid" => "1997"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;85:77-85"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2956
      "formatos" => array:3 [
        "EPUB" => 133
        "HTML" => 2180
        "PDF" => 643
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Catheter tip position and risk of mechanical complications in a neonatal unit"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "77"
          "paginaFinal" => "85"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Complicaciones mec&#225;nicas asociadas a la localizaci&#243;n de la punta de cat&#233;teres centrales en una unidad neonatal"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jose Maria Lloreda-Garc&#237;a, Ana Lorente-Nicol&#225;s, Francisca Bermejo-Costa, Jose Ram&#243;n Fern&#225;ndez-Fructuoso"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Jose Maria"
              "apellidos" => "Lloreda-Garc&#237;a"
            ]
            1 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Lorente-Nicol&#225;s"
            ]
            2 => array:2 [
              "nombre" => "Francisca"
              "apellidos" => "Bermejo-Costa"
            ]
            3 => array:2 [
              "nombre" => "Jose Ram&#243;n"
              "apellidos" => "Fern&#225;ndez-Fructuoso"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315004087"
        "doi" => "10.1016/j.anpedi.2015.10.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315004087?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300904?idApp=UINPBA00005H"
    "url" => "/23412879/0000008500000002/v1_201607230332/S2341287916300904/v1_201607230332/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2341287915002239"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.07.020"
    "estado" => "S300"
    "fechaPublicacion" => "2016-08-01"
    "aid" => "1986"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;85:61-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2562
      "formatos" => array:3 [
        "EPUB" => 171
        "HTML" => 1909
        "PDF" => 482
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Critically ill pediatric hemato-oncology patient&#58; What we do is what we should do&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "61"
          "paginaFinal" => "69"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Paciente cr&#243;nico oncohematol&#243;gico&#44; &#191;hacemos lo que deber&#237;amos hacer&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 3166
              "Ancho" => 2644
              "Tamanyo" => 252226
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Do you use HFOV if refractory hypoxemia and&#47;or hypoventilation to conventional mechanical ventilation&#63; &#40;b&#41; Respiratory management if refractory hypoxemia or hypoventilation to conventional mechanical ventilation&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Alberto Garc&#237;a-Salido, Montserrat Nieto-Moro, Mar&#237;a Isabel Iglesias-Bouzas, Marta Gonz&#225;lez-Vicent, Ana Serrano-Gonz&#225;lez, Juan Casado-Flores"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Alberto"
              "apellidos" => "Garc&#237;a-Salido"
            ]
            1 => array:2 [
              "nombre" => "Montserrat"
              "apellidos" => "Nieto-Moro"
            ]
            2 => array:2 [
              "nombre" => "Mar&#237;a Isabel"
              "apellidos" => "Iglesias-Bouzas"
            ]
            3 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Gonz&#225;lez-Vicent"
            ]
            4 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Serrano-Gonz&#225;lez"
            ]
            5 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Casado-Flores"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002239?idApp=UINPBA00005H"
    "url" => "/23412879/0000008500000002/v1_201607230332/S2341287915002239/v1_201607230332/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Pulmonary hypoplasia&#58; An analysis of cases over a 20-year period"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "70"
        "paginaFinal" => "76"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yanny Paola Delgado-Pe&#241;a, Alba Torrent-Vernetta, Gabriela Sacoto, In&#233;s de Mir-Messa, Sandra Rovira-Amigo, Silvia Gartner, Antonio Moreno-Gald&#243;, Jos&#233; Andr&#233;s Molino-Gahete, Fel&#237;x Castillo-Salinas"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "Yanny Paola"
            "apellidos" => "Delgado-Pe&#241;a"
            "email" => array:1 [
              0 => "yannypaola&#64;yahoo&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Alba"
            "apellidos" => "Torrent-Vernetta"
          ]
          2 => array:2 [
            "nombre" => "Gabriela"
            "apellidos" => "Sacoto"
          ]
          3 => array:2 [
            "nombre" => "In&#233;s"
            "apellidos" => "de Mir-Messa"
          ]
          4 => array:2 [
            "nombre" => "Sandra"
            "apellidos" => "Rovira-Amigo"
          ]
          5 => array:2 [
            "nombre" => "Silvia"
            "apellidos" => "Gartner"
          ]
          6 => array:2 [
            "nombre" => "Antonio"
            "apellidos" => "Moreno-Gald&#243;"
          ]
          7 => array:2 [
            "nombre" => "Jos&#233; Andr&#233;s"
            "apellidos" => "Molino-Gahete"
          ]
          8 => array:2 [
            "nombre" => "Fel&#237;x"
            "apellidos" => "Castillo-Salinas"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Hospital Universitario Vall d¿Hebron&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Hipoplasia pulmonar&#58; an&#225;lisis de la casu&#237;stica durante 20 a&#241;os"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1618
            "Ancho" => 1586
            "Tamanyo" => 69792
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve of cases of pulmonary hypoplasia&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pulmonary hypoplasia &#40;PH&#41; is a congenital anomaly characterised by impaired growth and development of the lung parenchyma&#44; airways and vessels&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#8211;5</span></a> Its incidence in the general population is of nine to eleven cases per 10&#44;000 live births&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;3</span></a> although this must be an underestimate since infants with lesser degrees of PH survive the neonatal period&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a> The prevalence of PH reported in perinatal autopsy case series ranges between 7&#46;8&#37; and 26&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;3</span></a> and it is the anomaly most frequently associated with perinatal mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Pulmonary hypoplasia most frequently develops secondary to abnormalities in the thoracic cavity&#44; foetal breathing movements&#44; foetal lung liquid at positive pressure and volume of amniotic fluid&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#8211;7</span></a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises and enumerates the underlying conditions most commonly associated to PH&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">4&#44;8&#44;9</span></a> The clinical manifestations depend on the degree of lung involvement&#44; ranging from severe bilateral forms to milder unilateral or lobar forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;10</span></a> During the neonatal period&#44; it can manifest with respiratory insufficiency&#44; pulmonary hypertension or pulmonary haemorrhage&#46; It characteristically presents with respiratory insufficiency of sudden onset that requires mechanical ventilation with high ventilatory pressures in the absence of atelectasis or obstruction&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;11</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The diagnosis can be suspected prenatally based on measurements of lung volume by means of three-dimensional &#40;3D&#41; ultrasound and magnetic resonance imaging &#40;MRI&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#44;13</span></a> The diagnostic tests used after birth are thoracic computed tomography &#40;CT&#41; and lung scintigraphy&#44; and the diagnosis is confirmed by pathologic examination&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#8211;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Different surgical approaches are used prenatally to attenuate the severity of PH in the foetus&#44; such as drainage in cases of hydrothorax or foetoscopic tracheal occlusion &#40;FETO&#41; in severe cases of congenital diaphragmatic hernia&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">14&#44;15</span></a> After birth&#44; the management of PH consists of supportive measures to guarantee adequate oxygenation during lung growth and development&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The established approach to the postnatal management of congenital diaphragmatic hernia is surgical repair followed by the use of invasive ventilatory support techniques with permissive hypercapnia combined with aggressive treatment for pulmonary hypertension&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">10&#44;15&#8211;18</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Recent studies have been pursuing the optimisation of the diagnostic methods&#44; treatments and postnatal care used in patients with PH&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> The aim of our study was to describe the aetiology&#44; diagnostic methods and clinical outcomes of cases of PH diagnosed in a tertiary university hospital&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">We conducted a descriptive retrospective study of patients with PH diagnosed between 1995 and 2014 at the Hospital Universitario Vall d&#8217;Hebron de Barcelona that received care in the departments of obstetrics&#44; neonatology&#44; paediatric surgery and paediatric pulmonology&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We analysed the following variables&#58; gestational age of the foetus at diagnosis&#44; prenatal ultrasound abnormalities&#44; prenatal surgery&#44; gestational age at birth&#44; age of onset of respiratory symptoms&#44; clinical manifestations&#44; aetiological diagnosis&#44; diagnostic tests used&#44; pathological findings&#44; laterality of lung involvement&#44; duration of required mechanical ventilation and oxygen supplementation&#44; clinical respiratory outcomes &#40;presence or absence of recurrent episodes of wheezing or infection&#41;&#44; pulmonary function outcomes&#44; quality of life and survival&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We studied the following prenatal surgical interventions&#58; insertion of pleural-amniotic shunts for drainage of amniotic fluid in cases of hydrothorax and FETO in patients with congenital diaphragmatic hernia that met the criteria of being 26 weeks or less of gestational age and with factors associated to high mortality&#44; such as a lung-to-head ratio &#40;LHR&#41; of less than 1 or herniation of the liver into the thoracic cavity&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The diagnosis of PH was based on pulmonary perfusion scintigraphy&#44; chest CT and clinical criteria&#46; The criteria for diagnosis were reduced pulmonary perfusion in scintigraphy and reduced volume of the lung and pulmonary vessels of the involved side compared to the contralateral side in CT&#46; The clinical diagnosis was based on the presence of respiratory distress syndrome of the neonate&#44; the need for mechanical ventilation at high pressures and plain chest radiography showing reduced aeration and small lung fields&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Lung function was assessed in cooperative children aged more than 5 years by means of forced spirometry&#44; plethysmography and single breath diffusion &#40;DLCO&#41; conforming to the standards set by the European Respiratory Society &#40;ERS&#41;&#46; Testing was performed with a Jaeger<span class="elsevierStyleSup">&#174;</span> spirometer and a Jaeger Masterscreen&#8482; plethysmograph &#40;CareFusion&#44; San Diego&#44; USA&#41;&#46; We have expressed the data as <span class="elsevierStyleItalic">z</span>-scores adjusted for sex&#44; age and height based on the reference equations of the Global Lung Initiative &#40;GLI&#41; of 2012 and Rosenthal&#44; respectively&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">To describe quality of life&#44; we reviewed data from the medical records of yearly check-up visits on factors such as schooling&#44; type of physical activity performed by the child&#44; and limitations in physical activity compared to healthy children of the same age&#46; We analysed survival by means of the Kaplan-Meyer method using SPSS version 21&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">We identified 60 cases&#44; 33 of which corresponded to male patients &#40;55&#37;&#41;&#46; There was unilateral involvement in 35 cases &#40;21 left and 15 right&#41; and bilateral involvement in 24 cases&#46; All patients had been assessed before birth by means of 3D ultrasound&#44; and abnormalities had been found in forty-six&#58; oligohydramnios in nineteen&#44; diaphragmatic hernia in twenty-one&#44; hydrothorax in six&#44; Jeune syndrome in two&#44; diaphragmatic eventration in one&#44; and polyhydramnios in one&#46; The mean gestational age at the first abnormal ultrasound was 27 weeks &#40;range&#44; 15&#8211;39 weeks&#41;&#46; Foetal MRI was performed in seven patients&#44; confirming the presence of congenital diaphragmatic hernia with reduced size of the ipsilateral lung in six patients and arthrogryposis with reduced size of both lungs in one patient&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">PH was classified as primary in four patients and secondary in fifty-six&#44; and congenital diaphragmatic hernia was the most frequent cause of PH &#40;41&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the aetiologies found in our study&#46; The diagnoses associated with the 19 cases of oligohydramnios were renal or urinary tract malformation &#40;6 cases&#41;&#44; premature rupture of membranes &#40;5 cases&#44; 3 of which were due to an invasive prenatal intervention&#41;&#44; hydrops fetalis &#40;3 cases&#41; and congenital diaphragmatic hernia &#40;1 case&#41;&#44; while the aetiology was not established in one case&#46; The mean LHR in patients with congenital diaphragmatic hernia was 0&#46;89 &#40;range&#44; 0&#46;29&#8211;4&#46;6&#41;&#46; Foetal surgery was performed in fifteen patients following the detection of abnormalities in ultrasound&#44; FETO was performed in eleven cases&#44; and a pleural-amniotic shunt placed in five&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The mean gestational age at birth was 33 weeks &#40;range&#44; 27&#8211;39 weeks&#41;&#46; Fifty patients had respiratory distress at birth&#44; of whom forty-seven &#40;94&#37;&#41; required mechanical ventilation due to severe hypoxaemia for a mean of nine days&#46; Eight patients had persistent pulmonary hypertension of the newborn&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The onset of symptoms occurred later in six patients that received a diagnosis of PH after being assessed for recurrent episodes of bronchitis&#46; The mean chronological age of diagnosis of these six patients was 45 days &#40;range&#44; 30&#8211;180&#41;&#46; Four patients did not develop any clinically significant respiratory symptoms and received the diagnosis of PH following the detection of dextrocardia in the first year of life&#44; and the presence of scimitar syndrome was subsequently confirmed in all&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The diagnosis of PH was suspected in 18 cases of early neonatal death &#40;31&#37;&#41; based on clinical features and compatible plain radiography findings&#46; In 31 cases &#40;51&#46;6&#37;&#41; PH was diagnosed based on chest CT or lung perfusion scintigraphy&#58; both techniques in 14 cases&#44; CT alone in 11 cases&#44; and scintigraphy alone in 6 cases&#46; In patients that underwent scintigraphy&#44; the average perfusion in the affected lung was 29&#37; &#40;range&#44; 8&#8211;44&#37;&#41;&#46; The diagnosis was confirmed by autopsy in 11 patients &#40;19&#37;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As for mortality&#44; a total of 28 patients &#40;47&#37;&#41; died in the first 60 days post birth&#44; with 25 dying in the perinatal period&#46; Seventy-five percent of the deaths occurred in the first day post birth&#46; Using the Kaplan&#8211;Meier method&#44; we estimated that the cumulative probability of death was 25&#37; at 12<span class="elsevierStyleHsp" style=""></span>h post birth and increased to 50&#37; by 60 days post birth &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Four patients were lost to followup&#44; while another 28 were followed up for an average of 5&#46;8 years &#40;range&#44; 0&#46;9&#8211;16&#41;&#46; Of all the patients that had required ventilatory support in the neonatal period&#44; six went on to require home mechanical ventilation &#40;two of them via tracheostomy&#41; for a median of 36 months&#44; and five required home oxygen therapy for a median of 4 months &#40;range&#44; 2&#8211;10 months&#41;&#46; One patient developed pulmonary hypertension&#46; Seventeen patients had recurrent respiratory conditions that were classified as pneumonia and recurrent bronchitis&#44; and four developed scoliosis&#46; We analysed the lung function tests performed in the past five years &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Spirometry manoeuvres met the acceptability criteria in 13 out of a total of 28 patients &#40;42&#46;8&#37;&#59; age range&#44; 5&#8211;17 years&#41;&#44; and plethysmography results were technically adequate in 11 of these 13 children&#46; Five patients had an obstructive pattern &#40;FEV1&#47;FVC<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>lower limits of normal &#91;LLN&#93;&#41;&#59; two had a restrictive pattern &#40;FVC<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>LLN and FEV1&#47;FVC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>LLN and TLC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>LLN&#41;&#59; and six had a normal pattern&#44; of whom two had air trapping&#46; Three patients had increased airway resistance&#46; Lung diffusion tests were normal in all 11 patients&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Twenty-two patients were able to attend school normally and had a normal exercise tolerance for their age&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">Pulmonary hypoplasia results from an arrest in normal lung development due to various factors that are not yet fully understood&#46; We present a detailed review of the patients that received a PH diagnosis in the past 20 years and were managed by an interdisciplinary team at a tertiary care university hospital&#46; We analysed its various causes and clinical presentation&#44; methods used for diagnosis&#44; treatments and outcomes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The aetiological distribution of the cases described in this study is consistent with the data found in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">8&#44;20&#44;21</span></a> according to which the most common congenital anomalies associated with PH are diaphragmatic hernia&#44; renal anomalies and skeletal anomalies&#46; We ought to mention other diseases found in our review&#44; such as premature rupture of membranes caused by invasive prenatal procedures such as multifoetal pregnancy reduction or amniocentesis&#44; genetic disorders &#40;trisomy 21&#41;&#44; and some that are less understood&#44; such as foetal akinesia&#47;hypokinesia sequence or Pena-Shokeir syndrome &#40;2 cases in our series&#41;&#44; characterised by polyhydramnios&#44; intrauterine growth restriction&#44; craniofacial and limb anomalies&#44; arthrogryposis&#44; short umbilical cord&#44; PH&#44; and a very low survival&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">22&#44;23</span></a> Cases of primary PH are rare and can be unilateral or lobar&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a> In our series&#44; only 7&#46;8&#37; of the cases were classified as primary PH&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Oligohydramnios was the mechanism associated with PH in one third of the cases in our series&#46; Nimrod et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> described a greater impact of premature membrane rupture in foetuses in which rupture occurred before 26 weeks&#8217; gestation and lasted more than five weeks&#44; while Rotschild et al&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a> detected pulmonary hypoplasia in up to 14&#37; of foetuses that experienced oligohydramnios following the rupture of membranes before 29 weeks&#8217; gestation&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Other authors have analysed the correlation between gestational age and the risk of having PH in association with oligohydramnios&#44; concluding that a duration of oligohydramnios of more than 14 days following the rupture of membranes before 25 weeks&#8217; gestation carries a risk of death due to PH of up to 90&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21&#44;22</span></a> While we did not establish patient subsets in our study to analyse the impact of oligohydramnios based on its duration and gestational age at the time of diagnosis&#44; we found that the mean gestational age at the time oligohydramnios was detected was 27 weeks&#44; which is consistent with the literature&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Also consistently with the literature&#44; the congenital malformation most frequently associated with PH was diaphragmatic hernia&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">10&#44;24&#44;25</span></a> This disease is the model that has been used most commonly for the study of early interventions&#44; the pathophysiology&#44; advances in perinatal care and the development of new diagnostic tools in PH&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> A distinctive aspect of congenital diaphragmatic hernia is that PH develops as an inherent feature of the disease and not solely as a result of lung compression&#44; and the mechanism by which the lung contralateral to the hernia is also affected remains unknown&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The prenatal diagnosis of PH and its confirmation in the early neonatal period are key in decreasing the morbidity and mortality associated to this disease&#46; Consequently&#44; the routine use of 3D ultrasound and MRI for prenatal diagnosis has become a care standard&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;16&#44;27&#44;28</span></a> The current ERS guidelines for the management of congenital diaphragmatic hernia include the use of MRI for the prenatal assessment of affected foetuses&#44; as it performs better than ultrasound in detecting herniation of the liver into the thorax&#44; differentiating diaphragmatic eventrations and accurate volumetry of both the contralateral and ipsilateral lungs&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a> Levine et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> performed MRI scans on 74 foetuses in whom ultrasound had detected thoracic abnormalities&#44; confirming that the use of a complementary noninvasive technique contributed additional information in up to 38&#37; of cases and led to changes in the management of 8&#37; of them&#46; All our patients were assessed by prenatal 3D ultrasound&#44; and patients with severe diaphragmatic hernia were also assessed by MRI&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Of the 24 patients in whom congenital diaphragmatic hernia was diagnosed as the cause of PH&#44; 11 were classified as being at high risk of dying and met the criteria for prenatal surgery&#44; so they underwent FETO&#46; Invasive prenatal surgical procedures have evolved from open surgery with placement of a tracheal clip to the FETO technique in which&#44; after ascertaining lung growth&#44; the balloon is removed prenatally&#46; These techniques have led to an increase in postnatal survival and a decrease in the incidence of secondary pulmonary hypertension&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">15&#44;30&#44;31</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">After birth&#44; PH may be suspected when plain radiography findings include diaphragmatic domes elevated up to the seventh rib&#44; a bell-shaped thorax&#44; downward sloping ribs&#44; pneumothorax or pneumomediastinum&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;3&#44;32</span></a> Pulmonary perfusion scintigraphy and chest computed tomography are very useful in confirming the diagnosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#44;32&#8211;37</span></a> In our series&#44; 50&#46;4&#37; of the cases were diagnosed by scintigraphy and CT&#44; 31&#37; by plain radiography and compatible clinical features &#40;cases that could not be confirmed by means of other techniques due to the early death of the patients&#41;&#44; and 19&#37; by autopsy&#46; The average measurement of perfusion by scintigraphy is used to determine the severity of PH&#44; which is considered moderate if perfusion in the involved lung is less than 40&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">33&#8211;35</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The perinatal mortality observed in our series was 41&#46;6&#37;&#44; which was consistent with the various series published in the literature that have described a high perinatal mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;4&#44;10&#44;15&#44;25</span></a> When we analysed our data&#44; we found that the cumulative probability of dying in the first 12<span class="elsevierStyleHsp" style=""></span>h post birth was 25&#37;&#44; and that this probability rose to 50&#37; by 60 days post birth&#44; a finding that underscored the need to have a highly specialised interdisciplinary team for the management of these patients during the early neonatal period&#46; The clinical manifestations observed most frequently during followup were pneumonia and recurrent bronchitis&#44; consistent with the course of disease described in patients that have undergone surgical repair of congenital diaphragmatic hernia and cases of late onset with similar symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">29&#44;37</span></a> Twenty-five percent of the patients that required mechanical ventilation in the neonatal period and survived required home mechanical ventilation and oxygen supplementation for a median of four months&#46; These data differ from the current literature&#44; which describes a shorter duration of respiratory support&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> This could be due to a lack of descriptive studies similar to the one we have performed in our population&#46; On the other hand&#44; 16&#37; of our patients developed scoliosis secondary to the unilateral reduction in lung volume&#46; Previous studies have shown that up to 16&#37; of children with a previous history of diaphragmatic hernia have some type of thoracic asymmetry&#44; such as scoliosis or pectus carinatum&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> Other longitudinal studies in children that had undergone surgical repair of diaphragmatic hernia showed catch-up lung growth and adequate exercise tolerance&#44; with children being able to lead normal lives despite the persistence of asymmetry in radiological images and a lack of changes in perfusion scans&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> Our study showed similar results&#44; as 77&#37; of the patients that survived in our series could attend school normally and had an adequate exercise tolerance for their age&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">When it comes to lung function tests&#44; some authors have described an obstructive airway pattern in patients with HP and proposed that bronchoscopy be performed to rule out tracheobronchomalacia&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a> Most studies have reported a predominance of restrictive airway patterns&#44; especially in patients requiring prolonged mechanical ventilation or oxygen therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">39&#44;40</span></a> In our case series&#44; few data on lung function were available because we only took into account the data collected in the past five years&#44; during which lung function testing was performed by the same technicians with the same equipment and adhering to the stringent quality and acceptability criteria published by the ERS&#44; to avoid potential biases&#46; Furthermore&#44; most of the patients in followup could not cooperate with spirometry or plethysmography&#46; Thus far&#44; our results have shown a higher proportion of children in followup with an obstructive pattern compared to a restrictive pattern based on spirometry as well as plethysmography&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In the past two decades&#44; there have been advances in the diagnostic techniques and prenatal interventions for PH&#44; and postnatal care for this disease has been optimised&#46; This has led to the improved management of these patients&#44; although the associated morbidity and mortality continue to be considerable&#46; We believe that further studies are required to assess the impact of these early interventions on future lung development&#46; Furthermore&#44; we must continue to do research to identify other factors that would allow changing the course of PH earlier and by less invasive methods&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">PH is a congenital anomaly that can be due to various causes and the prevalence of which is underestimated&#46; It is associated with a high neonatal mortality and significant long-term morbidity&#44; which calls for early diagnosis and intervention by a specialised interdisciplinary team&#46; The development of new diagnostic and surgical techniques has improved survival in these patients&#44; but further research is necessary to identify new factors that would allow changing the course of this disease&#44; along with long-term studies to assess the impact of these interventions&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interests</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres698461"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec708214"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres698462"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec708215"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interests"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-08-31"
    "fechaAceptado" => "2015-10-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec708214"
          "palabras" => array:3 [
            0 => "Pulmonary hypoplasia"
            1 => "Pulmonary agenesis"
            2 => "Congenital diaphragmatic hernia"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec708215"
          "palabras" => array:3 [
            0 => "Hipoplasia pulmonar"
            1 => "Agenesia pulmonar"
            2 => "Hernia diafragm&#225;tica cong&#233;nita"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pulmonary hypoplasia is the most frequent congenital anomaly associated with perinatal mortality&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective and descriptive review was conducted on cases of patients diagnosed with pulmonary hypoplasia between 1995 and 2014 in a tertiary university hospital&#46; An analysis was made of the prenatal imaging&#44; clinical manifestations&#44; post-natal diagnostic tests&#44; treatment and management&#44; long-term follow up&#44; and survival data&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 60 cases were identified&#44; all of them with prenatal imaging&#46; Sixteen patients required foetal surgery&#46; Congenital diaphragmatic hernia was the most frequent diagnosis&#46; Main clinical presentation was respiratory distress with severe hypoxaemia and high requirements of mechanical ventilation&#46; Mortality rate was 47&#37; within first 60 days of life&#44; and 75&#37; for the first day of life&#46; Pneumonia and recurrent bronchitis episodes were observed during follow-up&#46; They had a lung function obstructive pattern&#44; and their quality of life and exercise tolerance was good&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">High neonatal mortality and significant long-term morbidity associated with pulmonary hypoplasia requires an early diagnosis and a specialised multidisciplinary team management&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La hipoplasia pulmonar es la anomal&#237;a cong&#233;nita m&#225;s frecuentemente asociada a mortalidad perinatal&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio descriptivo retrospectivo de los casos de hipoplasia pulmonar diagnosticados entre 1995 y 2014 en un hospital universitario de tercer nivel&#44; analizando estudios prenatales&#44; manifestaciones cl&#237;nicas&#44; pruebas diagn&#243;sticas&#44; tratamiento&#44; datos de seguimiento a largo plazo y supervivencia&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 60 casos&#44; todos con estudio prenatal&#46; Diecis&#233;is recibieron intervenci&#243;n quir&#250;rgica intra&#250;tero&#46; La hernia diafragm&#225;tica cong&#233;nita fue la entidad m&#225;s frecuentemente asociada&#46; La manifestaci&#243;n cl&#237;nica m&#225;s habitual fue distr&#233;s respiratorio neonatal&#44; hipoxemia grave y necesidad de soporte con ventilaci&#243;n mec&#225;nica&#46; Se hall&#243; un 47&#37; de mortalidad antes de los 60 d&#237;as de vida y del 75&#37; en las primeras 24 h de vida&#46; Durante el seguimiento de los supervivientes se detectaron episodios de neumon&#237;as y bronquitis recidivantes&#44; funci&#243;n pulmonar con patr&#243;n obstructivo y aceptable calidad de vida y tolerancia al ejercicio&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La elevada mortalidad neonatal y la importante morbilidad a largo plazo de la hipoplasia pulmonar requieren de un diagn&#243;stico temprano y la intervenci&#243;n de un equipo multidisciplinar especializado&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Delgado-Pe&#241;a YP&#44; Torrent-Vernetta A&#44; Sacoto G&#44; de Mir-Messa I&#44; Rovira-Amigo S&#44; Gartner S&#44; et al&#46; Hipoplasia pulmonar&#58; an&#225;lisis de la casu&#237;stica durante 20 a&#241;os&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;85&#58;70&#8211;76&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1618
            "Ancho" => 1586
            "Tamanyo" => 69792
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve of cases of pulmonary hypoplasia&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities of the thoracic cavity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities in foetal lung fluid flow&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Abnormalities in foetal breathing movements&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Space-occupying lesions in the chest<br>Congenital diaphragmatic hernia<br>Malformation of the airways &#40;such as cystic adenomatoid malformation&#41;<br>Pleural effusion<br>Exomphalos<br>Gastroschisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Hypoplastic left or right heart<br>Pulmonary stenosis<br>Oligohydramnios<br>Renal agenesis<br>Cystic dysplasia<br>Urinary outflow obstruction<br>Prolonged rupture of membranes<br>Hydrops fetalis</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Neuromuscular disorders<br>Neurological problems<br>Pena-Shokeir syndrome</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chest wall malformations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kyphoscoliosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Skeletal dysplasias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1144692.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Classification of the underlying conditions that may cause secondary pulmonary hypoplasia&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Causes of pulmonary hypoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number of cases &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients that required mechanical ventilation in the neonatal period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients that received home mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diaphragmatic hernia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diaphragmatic paralysis-eventration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Renal&#47;urinary tract malformation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Invasive prenatal intervention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hydrops fetalis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Premature rupture of membranes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oligohydramnios of unknown aetiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Congenital hydrothorax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jeune syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Scimitar syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intrathoracic masses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unknown aetiology &#40;associated with Down syndrome&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Foetal akinesia&#47;hypokinesia sequence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary pulmonary hypoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;6&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1144693.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Distribution of aetiologies and outcomes of cases of pulmonary hypoplasia diagnosed between 1995 and 2014&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FVC <span class="elsevierStyleItalic">z</span>-score<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FEV1 <span class="elsevierStyleItalic">z</span>-score<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FEV1&#47;FVC <span class="elsevierStyleItalic">z</span>-score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TLC <span class="elsevierStyleItalic">z</span>-score<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Interpretation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Obstructive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;3&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Obstructive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Restrictive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;3&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Obstructive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;3&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;3&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Obstructive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Restrictive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;2&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;0&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Obstructive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Median <span class="elsevierStyleItalic">z</span>-score &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#8211;2&#46;06 &#40;&#8211;2&#46;84 to 1&#46;18&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#8211;2&#46;55 &#40;&#8211;3&#46;92 to 0&#46;84&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#8211;1 &#40;&#8211;3&#46;12 to 0&#46;37&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#8211;0&#46;25 &#40;&#8211;1&#46;88 to 1&#46;96&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1144694.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">z</span>-score&#58; Global Lung Function reference equations &#40;GLI&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">z</span>-score&#58; total lung capacity &#40;TLC&#41; plethysmography using the Rosenthal reference equations&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Results of the analysis of lung function tests performed in the past five years in children with pulmonary hypoplasia diagnosed between 1995 and 2014 at the Hospital Universitario Vall d&#8217;Hebron de Barcelona&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypoplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Porter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/fn.81.2.F81"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "1999"
                        "volumen" => "81"
                        "paginaInicial" => "F81"
                        "paginaFinal" => "F83"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10448173"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The fetal lung 2&#58; pulmonary hypoplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Laudy"
                            1 => "J&#46;M&#46; Wladimiroff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1469-0705.2000.00252.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2000"
                        "volumen" => "16"
                        "paginaInicial" => "482"
                        "paginaFinal" => "494"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11169336"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526016302448"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary unilateral pulmonary hypoplasia&#58; neonate through early childhood&#58; case report&#44; radiographic diagnosis and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Abrams"
                            1 => "V&#46;L&#46; Ackerman"
                            2 => "W&#46;A&#46; Engle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.jp.7211156"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Perinatol"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "667"
                        "paginaFinal" => "670"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15454946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypoplasia with hepatic and renal anomalies in a dead fetus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Ravindrakumar"
                            1 => "V&#46;S&#46; Devi"
                            2 => "U&#46;U&#46; Rani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/0970-2113.95329"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lung India"
                        "fecha" => "2012"
                        "volumen" => "29"
                        "paginaInicial" => "163"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22628933"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hipoplasia pulmonar infantil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Tortajada Girb&#233;s"
                            1 => "A&#46; Clement Paredes"
                            2 => "E&#46; Garc&#237;a Mu&#241;oz"
                            3 => "M&#46; Gracia Antequera"
                            4 => "F&#46; Delgado Cord&#243;n"
                            5 => "E&#46; Hern&#225;ndez Marc"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2007"
                        "volumen" => "67"
                        "paginaInicial" => "78"
                        "paginaFinal" => "79"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unilateral pulmonary agenesis&#44; aplasia and dysplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Dembinski"
                            1 => "M&#46; Kroll"
                            2 => "M&#46; Lewin"
                            3 => "P&#46;Z&#46; Winkler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Geburtshilfe Neonatol"
                        "fecha" => "2009"
                        "volumen" => "213"
                        "paginaInicial" => "56"
                        "paginaFinal" => "61"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hereditary renal adysplasia&#44; pulmonary hypoplasia and Mayer&#8211;Rokitansky&#8211;K&#252;ster&#8211;Hauser &#40;MRKH&#41; syndrome&#58; a case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Aci&#233;n"
                            1 => "F&#46; Gal&#225;n"
                            2 => "I&#46; Manch&#243;n"
                            3 => "E&#46; Ruiz"
                            4 => "M&#46; Aci&#233;n"
                            5 => "L&#46; Alcaraz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1750-1172-5-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Orphanet J Rare Dis"
                        "fecha" => "2010"
                        "volumen" => "5"
                        "paginaInicial" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20388228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human pulmonary hypoplasia&#58; statistical&#44; morphological&#44; morphometric&#44; and biochemical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Nakamura"
                            1 => "K&#46; Harada"
                            2 => "I&#46; Yamamoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pathol Lab Med"
                        "fecha" => "1992"
                        "volumen" => "116"
                        "paginaInicial" => "635"
                        "paginaFinal" => "642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1616425"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypoplasia-diaphragmatic hernia-anophthalmia-cardiac defect &#40;PDAC&#41; sindrome due to STRA6 mutations&#8212;what are the minimal criteria&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Segel"
                            1 => "E&#46; Levy-Lahad"
                            2 => "F&#46; Pasutto"
                            3 => "E&#46; Picard"
                            4 => "A&#46; Rauch"
                            5 => "G&#46; Alterescu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ajmg.a.33038"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Med Genet Part A"
                        "fecha" => "2009"
                        "volumen" => "149A"
                        "paginaInicial" => "2457"
                        "paginaFinal" => "2463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19839040"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314014156"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malformaciones cong&#233;nitas de las v&#237;as respiratorias inferiores"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Mart&#237;n"
                            1 => "M&#46; Benavides"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Pediatr Integral"
                        "fecha" => "2012"
                        "volumen" => "16"
                        "paginaInicial" => "62"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Apoyo ventilatorio domiciliario en ni&#241;os con insuficiencia respiratoria cr&#243;nica&#58; experiencia cl&#237;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; S&#225;nchez"
                            1 => "A&#46; Valenzuela"
                            2 => "P&#46; Bertrand"
                            3 => "C&#46; Alvarez"
                            4 => "N&#46; Holmgren"
                            5 => "S&#46; Vilches"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Chil Pediatr"
                        "fecha" => "2002"
                        "volumen" => "73"
                        "paginaInicial" => "51"
                        "paginaFinal" => "55"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital diaphragmatic hernia&#58; predictive value of MRI relative lung-to-head ratio compared with MRI fetal lung volume and sonographic lung-to-head ratio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;K&#46; Kilian"
                            1 => "T&#46; Schaible"
                            2 => "V&#46; Hofmann"
                            3 => "J&#46; Brade"
                            4 => "K&#46;W&#46; Neff"
                            5 => "K&#46;A&#46; B&#252;sing"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/AJR.08.1082"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR"
                        "fecha" => "2009"
                        "volumen" => "192"
                        "paginaInicial" => "153"
                        "paginaFinal" => "158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19098195"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predicting neonatal deaths and pulmonary hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume-body weight ratio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Ruano"
                            1 => "M&#46; Aubry"
                            2 => "Y&#46; Dumez"
                            3 => "M&#46; Zugaib"
                            4 => "A&#46; Benachi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/AJR.07.3078"
                      "Revista" => array:7 [
                        "tituloSerie" => "AJR"
                        "fecha" => "2008"
                        "volumen" => "190"
                        "paginaInicial" => "1216"
                        "paginaFinal" => "1219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18430834"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314020828"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The outcome of isolated primary fetal hydrothorax&#58; a 10 year review from a tertiary center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Petersen"
                            1 => "R&#46; Kaur"
                            2 => "J&#46;T&#46; Thomas"
                            3 => "R&#46; Cincotta"
                            4 => "G&#46; Gardener"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000351855"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fetal Diagn Ther"
                        "fecha" => "2013"
                        "volumen" => "34"
                        "paginaInicial" => "69"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23817182"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tratamiento intrauterino de la hernia diafragm&#225;tica cong&#233;nita grave mediante oclusi&#243;n traqueal fetosc&#243;pica&#46; Protocolo europeo de colaboraci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Peir&#243;"
                            1 => "E&#46; Gratac&#243;s"
                            2 => "J&#46; Carreras"
                            3 => "J&#46; LLoret"
                            4 => "N&#46; Toran"
                            5 => "S&#46; Salcedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Cir Infantil"
                        "fecha" => "2005"
                        "volumen" => "15"
                        "paginaInicial" => "28"
                        "paginaFinal" => "33"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital diaphragmatic hernia&#58; where and what is the evidence&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;D&#46; Losty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Pediatr Surg"
                        "fecha" => "2014"
                        "volumen" => "23"
                        "paginaInicial" => "78"
                        "paginaFinal" => "82"
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314020257"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary development considerations in the surgical management of congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Kholdebarin"
                            1 => "B&#46; Iwasiow"
                            2 => "R&#46; Keijzer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.earlhumdev.2011.08.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "Early Hum Dev"
                        "fecha" => "2011"
                        "volumen" => "87"
                        "paginaInicial" => "755"
                        "paginaFinal" => "758"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21920679"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of very prolonged membrane rupture on fetal development"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Nimrod"
                            1 => "F&#46; Varela-gittings"
                            2 => "G&#46; Machin"
                            3 => "D&#46; Campbell"
                            4 => "R&#46; Wesemberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Obstet Gynecol"
                        "fecha" => "1984"
                        "volumen" => "148"
                        "paginaInicial" => "540"
                        "paginaFinal" => "543"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6702914"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314016593"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term follow-up of patients with high risk congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Kamata"
                            1 => "N&#46; Usui"
                            2 => "M&#46; Kamiyama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpedsurg.2005.08.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Surg"
                        "fecha" => "2005"
                        "volumen" => "40"
                        "paginaInicial" => "1833"
                        "paginaFinal" => "1838"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16338300"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neonatal outcome after prolonged preterm rupture of membranes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Rostschild"
                            1 => "E&#46;W&#46; Ling"
                            2 => "M&#46; Puterman"
                            3 => "D&#46; Farquharson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Obstet Gynecol"
                        "fecha" => "1990"
                        "volumen" => "162"
                        "paginaInicial" => "46"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2301516"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preterm premature rupture of the membranes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Mercer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Obstet Gynecol"
                        "fecha" => "2003"
                        "volumen" => "101"
                        "paginaInicial" => "178"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12517665"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Secuencia de hipokinesia fetal &#40;fenotipo de Pena Shokeir tipo <span class="elsevierStyleSmallCaps">I</span>&#41;&#46; Sobrevida y calidad de vida&#46; Enfoque multidisciplinario"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Rossato"
                            1 => "G&#46; Fernandez"
                            2 => "K&#46; Ja"
                            3 => "R&#46; Sod"
                            4 => "M&#46; Busso"
                            5 => "L&#46; di Lillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Argent Pediatr"
                        "fecha" => "2005"
                        "volumen" => "103"
                        "paginaInicial" => "430"
                        "paginaFinal" => "434"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of pulmonary artery agenesis and hypoplasia of the lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Vitiello"
                            1 => "C&#46; Pisanti"
                            2 => "A&#46; Pisanti"
                            3 => "M&#46; Silberbach"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ppul.20421"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Pulmonol"
                        "fecha" => "2006"
                        "volumen" => "41"
                        "paginaInicial" => "897"
                        "paginaFinal" => "899"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16850441"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314018154"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pediatric chest <span class="elsevierStyleSmallCaps">I</span>&#58; developmental and physiologic conditions for the surgeon"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Guidry"
                            1 => "E&#46; McGahren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.suc.2012.03.013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Surg Clin N Am"
                        "fecha" => "2012"
                        "volumen" => "92"
                        "paginaInicial" => "615"
                        "paginaFinal" => "643"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22595712"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0890856713001937"
                          "estado" => "S300"
                          "issn" => "08908567"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital diaphragmatic hernia&#8212;mechanisms of pulmonary hipoplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Labb&#233;"
                            1 => "K&#46; Coste"
                            2 => "P&#46;J&#46; D&#233;chelotte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmr.2010.10.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Mal Respir"
                        "fecha" => "2011"
                        "volumen" => "28"
                        "paginaInicial" => "463"
                        "paginaFinal" => "474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21549902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "RM fetal&#58; patolog&#237;a tor&#225;cica y abdomino-p&#233;lvica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Recio"
                            1 => "P&#46; Mart&#237;nez"
                            2 => "J&#46; P&#233;rez"
                            3 => "C&#46; Bermejo"
                            4 => "I&#46; Tamarit"
                            5 => "I&#46; Pastor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Argent Radiol"
                        "fecha" => "2012"
                        "volumen" => "76"
                        "paginaInicial" => "1"
                        "paginaFinal" => "28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fetal thoracic abnormalities&#58; MR imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Levine"
                            1 => "C&#46;E&#46; Barnewolt"
                            2 => "T&#46;S&#46; Mehta"
                            3 => "I&#46; Trop"
                            4 => "J&#46; Estroff"
                            5 => "G&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2282020604"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2003"
                        "volumen" => "228"
                        "paginaInicial" => "379"
                        "paginaFinal" => "388"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12821772"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fetal MRI-calculated total lung volumes in the prediction of short-term outcome in giant omphalocele&#58; preliminary findings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Danzer"
                            1 => "T&#46; Victoria"
                            2 => "M&#46; Bebbington"
                            3 => "J&#46; Siegle"
                            4 => "N&#46; Rintoul"
                            5 => "M&#46; Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000334284"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fetal Diagn Ther"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "248"
                        "paginaFinal" => "253"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22572017"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital diaphragmatic hernia&#46; ERS Task force report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Kotecha"
                            1 => "A&#46; Barbato"
                            2 => "A&#46; Bush"
                            3 => "F&#46; Claus"
                            4 => "M&#46; Davenport"
                            5 => "C&#46; Delacourt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00066511"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2012"
                        "volumen" => "39"
                        "paginaInicial" => "820"
                        "paginaFinal" => "829"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22034651"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526016302448"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Innovations in the surgical management of congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Tsao"
                            1 => "K&#46; Lally"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clp.2012.04.002"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Perinatol"
                        "fecha" => "2012"
                        "volumen" => "39"
                        "paginaInicial" => "363"
                        "paginaFinal" => "374"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22682385"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314021111"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early fetoscopic tracheal occlusion for extremely severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia&#58; preliminary results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Ruano"
                            1 => "J&#46; Peir&#243;"
                            2 => "M&#46; Silvas"
                            3 => "J&#46; Campos"
                            4 => "E&#46; Carreras"
                            5 => "U&#46; Tannuris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.12414"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2013"
                        "volumen" => "42"
                        "paginaInicial" => "70"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23349059"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hipoplasia pulmonar&#58; causa de errores diagn&#243;sticos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Salcedo"
                            1 => "A&#46; Rodriguez"
                            2 => "A&#46; de la Huerga"
                            3 => "I&#46; Marsiinyach"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Pediatr Esp"
                        "fecha" => "2006"
                        "volumen" => "64"
                        "paginaInicial" => "260"
                        "paginaFinal" => "268"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mid- and long-term effects on pulmonary perfusi&#243;n&#44; anatomy and diaphragmatic motility in survivors of congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Arena"
                            1 => "S&#46; Baldari"
                            2 => "A&#46; Centorrino"
                            3 => "M&#46; Calabr&#243;"
                            4 => "G&#46; Pajino"
                            5 => "S&#46; Arena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00383-005-1557-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Surg Int"
                        "fecha" => "2005"
                        "volumen" => "21"
                        "paginaInicial" => "954"
                        "paginaFinal" => "959"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16240135"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary morbidity in 100 survivors of congenital diaphragmatic hernia monitored in a multidisciplinary clinic"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;S&#46; Muratore"
                            1 => "V&#46; Kharasch"
                            2 => "D&#46;P&#46; Lund"
                            3 => "C&#46; Sheils"
                            4 => "S&#46; Friedman"
                            5 => "C&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/jpsu.2001.20031"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Surg"
                        "fecha" => "2001"
                        "volumen" => "36"
                        "paginaInicial" => "133"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11150452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for lung scintigraphy in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Ciofeta"
                            1 => "A&#46; Piepsz"
                            2 => "I&#46; Roca"
                            3 => "S&#46; Fisher"
                            4 => "K&#46; Hahn"
                            5 => "R&#46; Sixt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00259-007-0485-3"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Nucl Med Mol Imaging"
                        "fecha" => "2007"
                        "volumen" => "34"
                        "paginaInicial" => "1518"
                        "paginaFinal" => "1526"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17602223"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0167527314007050"
                          "estado" => "S300"
                          "issn" => "01675273"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital anomalies of the tracheobronchial tree&#44; lung and mediastinum&#58; embryology&#44; radiology and pathology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Berrocal"
                            1 => "C&#46; Madrid"
                            2 => "S&#46; Novo"
                            3 => "J&#46; Gutierrez"
                            4 => "A&#46; Arjonilla"
                            5 => "N&#46; G&#243;mez-Le&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.e17"
                      "Revista" => array:5 [
                        "tituloSerie" => "Radiographics"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "e17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14610245"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hipoplasia pulmonary en el adulto"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;A&#46; Carmona-Ruiz"
                            1 => "M&#46; Lamothe-Ibarra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Int Mex"
                        "fecha" => "2014"
                        "volumen" => "30"
                        "paginaInicial" => "348"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Right-sided pulmonary aplasia&#58; longitudinal lung function studies in two cases and comparison to results from healthy term neonates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Nowotny"
                            1 => "B&#46; Ahrens"
                            2 => "K&#46; Bittigau"
                            3 => "S&#46; Buttenberg"
                            4 => "H&#46; Hammer"
                            5 => "K&#46; Kalache"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Pulmonol"
                        "fecha" => "1998"
                        "volumen" => "26"
                        "paginaInicial" => "138"
                        "paginaFinal" => "144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9727767"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0920996413006610"
                          "estado" => "S300"
                          "issn" => "09209964"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective longitudinal evaluation of lung function during first year of life after repair of congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Spoel"
                            1 => "L&#46; ven den Hout"
                            2 => "S&#46;J&#46; Gischler"
                            3 => "W&#46; Hop"
                            4 => "I&#46; Reiss"
                            5 => "D&#46; Tibboel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/PCC.0b013e3182231872"
                      "Revista" => array:5 [
                        "tituloSerie" => "Paediatr Crit Care"
                        "fecha" => "2012"
                        "volumen" => "13"
                        "paginaInicial" => "e133-9"
                        "itemHostRev" => array:3 [
                          "pii" => "S0022395613001556"
                          "estado" => "S300"
                          "issn" => "00223956"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of early lung function in patients with congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Wright"
                            1 => "A&#46; Filbrun"
                            2 => "B&#46; Bryner"
                            3 => "G&#46; Mychaliska"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/jpedsurg.2014.01.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Surg"
                        "fecha" => "2014"
                        "volumen" => "49"
                        "paginaInicial" => "882"
                        "paginaFinal" => "885"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24888827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008500000002/v1_201607230332/S2341287916300850/v1_201607230332/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008500000002/v1_201607230332/S2341287916300850/v1_201607230332/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916300850?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2015.10.022

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	22	14	36
2024 October	146	73	219
2024 September	141	48	189
2024 August	134	90	224
2024 July	129	46	175
2024 June	129	44	173
2024 May	131	56	187
2024 April	136	51	187
2024 March	128	45	173
2024 February	115	41	156
2024 January	132	47	179
2023 December	161	33	194
2023 November	165	36	201
2023 October	111	38	149
2023 September	106	36	142
2023 August	96	24	120
2023 July	130	29	159
2023 June	111	35	146
2023 May	148	29	177
2023 April	105	24	129
2023 March	124	37	161
2023 February	119	20	139
2023 January	113	20	133
2022 December	91	29	120
2022 November	117	53	170
2022 October	88	48	136
2022 September	78	40	118
2022 August	87	48	135
2022 July	59	44	103
2022 June	75	33	108
2022 May	101	59	160
2022 April	79	49	128
2022 March	107	60	167
2022 February	121	35	156
2022 January	140	40	180
2021 December	86	56	142
2021 November	99	68	167
2021 October	107	75	182
2021 September	103	67	170
2021 August	112	52	164
2021 July	120	46	166
2021 June	97	69	166
2021 May	152	75	227
2021 April	275	97	372
2021 March	171	65	236
2021 February	139	42	181
2021 January	181	29	210
2020 December	147	40	187
2020 November	123	28	151
2020 October	118	29	147
2020 September	105	32	137
2020 August	141	28	169
2020 July	108	24	132
2020 June	97	29	126
2020 May	128	36	164
2020 April	150	30	180
2020 March	211	19	230
2020 February	124	28	152
2020 January	142	28	170
2019 December	111	42	153
2019 November	119	23	142
2019 October	137	32	169
2019 September	103	27	130
2019 August	115	33	148
2019 July	80	45	125
2019 June	91	30	121
2019 May	161	37	198
2019 April	112	50	162
2019 March	83	32	115
2019 February	65	28	93
2019 January	151	43	194
2018 December	161	39	200
2018 November	148	41	189
2018 October	244	28	272
2018 September	109	17	126
2018 July	2	0	2
2018 June	3	0	3
2018 May	5	0	5
2018 April	18	0	18
2018 March	32	0	32
2018 February	18	0	18
2018 January	18	0	18
2017 December	19	0	19
2017 November	24	0	24
2017 October	26	0	26
2017 September	41	0	41
2017 August	23	0	23
2017 July	33	0	33
2017 June	62	12	74
2017 May	43	14	57
2017 April	23	11	34
2017 March	15	7	22
2017 February	10	12	22
2017 January	15	9	24
2016 December	23	15	38
2016 November	42	21	63
2016 October	38	26	64
2016 September	40	8	48
2016 August	62	13	75
2016 July	21	7	28

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter