PuRPOSE Study
PUrPOSE Study - Point of Care Ultrasound in CDH: Predicting Outcomes and Success of Extubation
Contact Information
Please contact us if a patient at MUHC or CHOP interested in participating to this study within the prenatal setting, in order for us to communicate with them for consent.
MCH: info@neocardiolab.com and gabriel.altit@mcgill.ca
CHOP: fragam@chop.edu (co-PI - Dr Maria Fraga)
Dr Maria V Fraga and her team from the Children's Hospital of Philadelphia are key collaborators. We are launching a study on the use of Lung ultrasound in congenital diaphragmatic hernia - "PUrPOSE Study - Point of Care Ultrasound in Congenital Diaphragmatic Hernia: Predicting Outcomes and Success of Extubation". Dr Fraga is a senior neonatologist, world renowned for her work on point of care ultrasound in the neonatal period. She is the co-chair of the famous POCUS course at CHOP. She is also an expert in hemodynamics management in critically ill newborns. The project we are launching in partnership will be supported by the Frontier Program of Dr. Holly Hedrick, a senior scientist and surgeon at CHOP who has done pioneering work in congenital diaphragmatic hernia and a key member of the bigger team working on PUrPOSE.
Co-Investigators - CHOP: Holly Hedrick, MD; Natalie Rintoul, MD; Anne Ades, MD; Katherine Avitabile, MD; Howard Panitch, MD; Leny Matthews; Jennifer Davis; Juliana Gebbs, MD; Sandy Johng, MD
Co-Investigators – MCH: Guilherme Sant’Anna, MD (Neonatologist); Pramod Puligandla. MD (Pediatric Surgery); Adam Shapiro, MD (Pediatric Respirology); Parent Partners: Ode Lunardi, Alina Gotcherian
Summary Figure (Procedures)
Important Documents (Protocol, Consent Forms, Data collection form)




Procedure for LUS step-by-step at CHOP
Place order on EPIC: NICU-Performed Research Ultrasound
Bring up the patient on the worklist on the Ultrasound machine-choose patient
No need to put patient ID on first clip
Use LUNG preset: Marker top left, loop time: 5 secs, depth 3 cm. XRES off.
Specify marker on image: Right lung - Upper; Right lung - Lower; Right lung-Lateral
Specify marker on image: Left lung - Upper; Left lung - Lower; Left lung-Lateral
Machine: Philips CX50
Probe: L15-7 (Hockey Stick)
For LUS in delivery room and at 12 hours: only scan the contralateral lung to the CDH
For pre-extubation LUS: Scan both lungs
End exam.
Scanning
Scanning: We scan in the longitudinal axis. Tip of Hockey stick pointing 12 o’clock (towards the head; tail of probe towards the lower body).
We divide the chest and indicate on each clip the corresponding position of scanning: Only one clip and one M-mode acquisition per quadrant (no need for repeated clips):
Right Lung:
A) Right Upper Anterior (along mid-clavicular line) – Clip sliding from clavicula to nipple line, followed by one M-Mode acquisition.
B) Right Lower Anterior (along mid-clavicular line) - Clip sliding from nipple line to costal margin, followed by one M-Mode acquisition.
C) Right Lateral (along mid-axillary line) - Clip sliding from axilla to costal margin (where you visualize the lung-diaphragm interface), followed by one M-Mode acquisition.
Left lung:
A) Left Upper Anterior (along mid-clavicular line) - Clip sliding from clavicula to nipple line, followed by one M-Mode acquisition.
B) Left Lower Anterior (along mid-clavicular line) - Clip sliding from nipple line to costal margin, followed by one M-Mode acquisition.
C) Left Lateral (along mid-axillary line) - Clip sliding from axilla to costal margin (where you visualize the lung-diaphragm interface), followed by one M-Mode acquisition.
If Left CDH:
LUS 1 and 2: Right chest scanning (3 right zones clips + 3 right zones M-Modes)
LUS 3 (pre-extubation): Both chest scanning (6 zones clips + 6 zones M-Modes)
If Right CDH:
LUS 1 and 2: Left chest scanning (3 left zones clips + 3 left zones M-Modes)
LUS 3 (pre-extubation): Both chest scanning (6 zones clips + 6 zones M-Modes)
Video on How to Perform the Lung Ultrasound
Thanks to Daniela Villegas Martinez for the filming!
A special thanks to Dr Maria Fraga from Children's Hospital of Philadelphia (co-PI of the PuRPOSE Study) for reviewing the content and providing guidance for the preparation, orchestration and content review.
Thanks to Florence and her family for accepting to be part of the filming!