OBJECTIVE: To evaluate whether infants with congenital diaphragmatic hernia (CDH) can be safely resuscitated with a reduced starting fraction of inspired oxygen (FiO2) of 0.5. STUDY DESIGN: A retrospective cohort study comparing 68 patients resuscitated with starting FiO2 0.5 to 45 historical controls resuscitated with starting FiO2 1.0. RESULTS: Reduced starting FiO2 had no adverse effect upon survival, duration of intubation, need for ECMO, duration of ECMO, or time to surgery. Furthermore, it produced no increase in complications, adverse neurological events, or neurodevelopmental delay. The need to subsequently increase FiO2 to 1.0 was associated with female sex, lower gestational age, liver up, lower lung volume-head circumference ratio, decreased survival, a higher incidence of ECMO, longer time to surgery, periventricular leukomalacia, and lower neurodevelopmental motor scores. CONCLUSION: Starting FiO2 0.5 may be safe for the resuscitation of CDH infants. The need to increase FiO2 to 1.0 during resuscitation is associated with worse outcomes.
OBJECTIVE: To evaluate whether infants with congenital diaphragmatic hernia (CDH) can be safely resuscitated with a reduced starting fraction of inspired oxygen (FiO2) of 0.5. STUDY DESIGN: A retrospective cohort study comparing 68 patients resuscitated with starting FiO2 0.5 to 45 historical controls resuscitated with starting FiO2 1.0. RESULTS: Reduced starting FiO2 had no adverse effect upon survival, duration of intubation, need for ECMO, duration of ECMO, or time to surgery. Furthermore, it produced no increase in complications, adverse neurological events, or neurodevelopmental delay. The need to subsequently increase FiO2 to 1.0 was associated with female sex, lower gestational age, liver up, lower lung volume-head circumference ratio, decreased survival, a higher incidence of ECMO, longer time to surgery, periventricular leukomalacia, and lower neurodevelopmental motor scores. CONCLUSION: Starting FiO2 0.5 may be safe for the resuscitation of CDHinfants. The need to increase FiO2 to 1.0 during resuscitation is associated with worse outcomes.
Authors: Lucy Chai See Lum; Tindivanum Muthurangam Ramanujam; Yee Ian Yik; Mei Ling Lee; Soo Lin Chuah; Emer Breen; Anis Siham Zainal-Abidin; Srihari Singaravel; Conjeevaram Rajendrarao Thambidorai; Jessie Anne de Bruyne; Anna Marie Nathan; Surendran Thavagnanam; Kah Peng Eg; Lucy Chan; Mohamed E Abdel-Latif; Chin Seng Gan Journal: BMC Pediatr Date: 2022-07-07 Impact factor: 2.567
Authors: Elizabeth E Foglia; Anne Ades; Holly L Hedrick; Natalie Rintoul; David A Munson; Julie Moldenhauer; Juliana Gebb; Bonnie Serletti; Aasma Chaudhary; Danielle D Weinberg; Natalie Napolitano; María Victoria Fraga; Sarah J Ratcliffe Journal: Arch Dis Child Fetal Neonatal Ed Date: 2019-08-28 Impact factor: 5.747
Authors: Philip L J DeKoninck; Emily J J Horn-Oudshoorn; Ronny Knol; Kelly J Crossley; Irwin K M Reiss Journal: Front Pediatr Date: 2021-12-14 Impact factor: 3.418