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In animal models of congenital diaphragmatic hernia (CDH), tracheal occlusion (TO) has induced maturation of both airway spaces and vascular structures. Airway and vascular response to TO are assumed to occur in parallel. This study aims to describe and measure the relationship between airway and vascular maturation induced by TO.A rabbit model of CDH on gestational day (GD) 23 and TO on GD 28 (term = GD 31) has been used. Two study groups have been defined: DH (diaphragmatic hernia) and TO (DH treated with TO). Animals were collected on GD 30 and blood flow data of the pulmonary artery (pulsatility index (PI) and fractional moving blood volume) were ultrasonographically measured. Lung morphometry consisted of measurements of radial alveolar count (RAC) and arterial muscular thickness.Animals in the DH group (n = 9) had the worst hemodynamic parameters; their lungs were hypoplastic and had the thickest arterial muscular layer. Animals in the TO group (n = 10) had all these effects reversed. There were no correlations among hemodynamic, airway, and vascular parameters, except for RAC and PI (r = -0.528, P = 0.043).Airway and vascular maturation after TO appear to be uncorrelated effects. TO could trigger several pathways that separately regulate airway and vascular responses.

517 Characterisation of Lung Mechanics After Fetal Tracheal Occlusion in Newborn Rabbits with Lung Hypoplasia Induced by Diaphragmatic Hernia (CDH)

Background and Aims: Feeding difficulties and nutritional compromise are recognised sequelae in survivors following congenital diaphragmatic hernia (CDH) repair. This study aims to investigate factors which may influence oral feeding behaviour in this complex group. Methods: Data analysis on 35 survivors of 61 CDH patients between 2007 and 2010. Results: 16 (46%) of 35 patients had oral feeding problems (OFP) and had a speech and language therapy (SALT) assessment. (table 1) 6 (38%) of those required a gastrostomy. Ventilator days for patients with oral aversion was 26.5 versus 19 days in those without ( P< 0.01). (table 2) 21 patients had had antenatal fetal endoscopic tracheal occlusion (FETO) of whom 11(52%) had OFP. 12 (75%) of the OFP group had a patch repair versus 10 (53%) in the non OFP group. Conclusion: In our study, almost half of the survivors had OFP, particularly those with a prolonged ventilatory course. Many required long term input in specialist feeding clinics. This information is important for counselling and suggests that early SALT and nutritional assessment and intervention are essential.

139 Is the Expression of Vegf Altered After Tracheal Occlusion in Experimental Model of Congenital Diaphragmatic Hernia?

182 Improving Results with Percutaneous Fetal Endoscopic Tracheal Occlusion (FETO) for Severe Left Congenital Diaphragmatic Hernia.

A review of: Kitano Y, Von Allmen D, Kanai M, et al. 2001 Fetal lung growth after short-term tracheal occlusion is linearly related to intratracheal pressure. J Appl Physiol 90:493–500; and Zheng W, Seftor EA, Meininger CJ, et al. 2001 Mechanisms of coronary angiogenesis in response to stretch: role of VEGF and TGF-beta. Am J Physiol Heart Circ Physiol 280: H909–917

The Impact of Maternal Terbutaline Administration on Lung Growth Following Prenatal Tracheal Occlusion

Fetal Tracheal Occlusion : Antenatal Steroid Potentiates the Effect of Occlusion Release on Lung Maturation

Effects of Fetal Tracheal Occlusion (TO) on Alveolar Type 2 Cell Number and Maturation in the Rat