Theresa R Grover1, Karna Murthy2, Beverly Brozanski3, Jason Gien1, Natalie Rintoul4, Sarah Keene5, Tasnim Najaf6, Louis Chicoine7, Nicolas Porta2, Isabella Zaniletti8, Eugenia K Pallotto9. 1. Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado. 2. Ann and Robert H. Lurie Children's Hospital and Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 3. Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 4. Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. 5. Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia. 6. Washington University, St. Louis, Missouri. 7. Nationwide Children's Hospital, Columbus, Ohio. 8. Children's Hospital Association, Overland Park, Kansas. 9. Children's Mercy Hospital and University of Missouri, Kansas City, Missouri.
Abstract
OBJECTIVE: The aim of this study is to characterize medical and surgical therapies and short-term outcomes in infants with congenital diaphragmatic hernia (CDH). STUDY DESIGN: Retrospective analysis of CDH infants admitted to 27 children's hospitals submitting data to Children's Hospital Neonatal Database (CHND) from 2010 to 2013, stratified by gestational age, birth weight, and survival. RESULTS: A total of 572 infants were identified, 508 (89%) born ≥ 34 weeks' gestation and ≥ 2 kg. More mature infants had higher APGAR scores, shorter duration of mechanical ventilation, and were more likely to receive extracorporeal membrane oxygenation (ECMO). Overall, mortality for the cohort was 29%, with mortality lower in infants born ≥ 34 weeks' gestation and ≥ 2 kg (26 vs. 50%, p < 0.01). Nonsurvivors were more likely to receive treatment with high-frequency oscillatory ventilation (HFOV), vasopressors, pulmonary vasodilators, and ECMO, and to have associated major congenital anomalies than survivors. In hospital morbidity and complications were relatively uncommon among survivors. CONCLUSION: Infants with CDH have a high risk of morbidity and mortality, and for preterm infants with CDH those risks are amplified. Patterns of respiratory and circulatory support appeared to be different for survivors. In addition to established data registries, this consortium of regional neonatal intensive care units provides a new collaborative effort to describe short-term outcomes for infants referred with CDH. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: The aim of this study is to characterize medical and surgical therapies and short-term outcomes in infants with congenital diaphragmatic hernia (CDH). STUDY DESIGN: Retrospective analysis of CDH infants admitted to 27 children's hospitals submitting data to Children's Hospital Neonatal Database (CHND) from 2010 to 2013, stratified by gestational age, birth weight, and survival. RESULTS: A total of 572 infants were identified, 508 (89%) born ≥ 34 weeks' gestation and ≥ 2 kg. More mature infants had higher APGAR scores, shorter duration of mechanical ventilation, and were more likely to receive extracorporeal membrane oxygenation (ECMO). Overall, mortality for the cohort was 29%, with mortality lower in infants born ≥ 34 weeks' gestation and ≥ 2 kg (26 vs. 50%, p < 0.01). Nonsurvivors were more likely to receive treatment with high-frequency oscillatory ventilation (HFOV), vasopressors, pulmonary vasodilators, and ECMO, and to have associated major congenital anomalies than survivors. In hospital morbidity and complications were relatively uncommon among survivors. CONCLUSION:Infants with CDH have a high risk of morbidity and mortality, and for preterm infants with CDH those risks are amplified. Patterns of respiratory and circulatory support appeared to be different for survivors. In addition to established data registries, this consortium of regional neonatal intensive care units provides a new collaborative effort to describe short-term outcomes for infants referred with CDH. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Ian C Glenn; Sophia Abdulhai; Neil L McNinch; Pamela A Lally; Todd A Ponsky; Avraham Schlager Journal: Pediatr Surg Int Date: 2018-05-28 Impact factor: 1.827
Authors: K Murthy; E K Pallotto; J Gien; B S Brozanski; N F M Porta; I Zaniletti; S Keene; L G Chicoine; N E Rintoul; F D Dykes; J M Asselin; B L Short; M A Padula; D J Durand; K M Reber; J R Evans; T R Grover Journal: J Perinatol Date: 2016-03-10 Impact factor: 2.521
Authors: Yigit S Guner; Patrick T Delaplain; Lishi Zhang; Matteo Di Nardo; Thomas V Brogan; Yanjun Chen; John P Cleary; Peter T Yu; Matthew T Harting; Henri R Ford; Danh V Nguyen Journal: ASAIO J Date: 2019-07 Impact factor: 2.872