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Research: Congenital diaphragmatic hernia presenting with symptoms within the first day of life; outcomes from a non-ECMO centre in Denmark.

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Research: Congenital diaphragmatic hernia presenting with symptoms within the first day of life; outcomes from a non-ECMO centre in Denmark.

BMC Pediatr. 2020 May 7;20(1):196. doi: 10.1186/s12887-020-02072-2. https://www.ncbi.nlm.nih.gov/pubmed/32381070

Congenital diaphragmatic hernia presenting with symptoms within the first day of life; outcomes from a non-ECMO centre in Denmark.

Larsen UL1,2Jepsen S3Strøm T4Qvist N5Toft P4.

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Abstract

BACKGROUND:

Between 1998 and 2015, we report on the survival of congenital diaphragmatic hernia (CDH)-infants presenting with symptoms within the first 24 h of life, treated at Odense University Hospital (OUH), a tertiary referral non-extracorporeal membrane oxygenation (ECMO) hospital for paediatric surgery.

METHODS:

We performed a retrospective cohort study of prospectively identified CDH-infants at our centre. Data from medical records and critical information systems were obtained. Baseline data included mode of delivery and infant condition. Outcome data included 24-h, 28-day, and 1 year mortality rates and management data included intensive care treatment, length of stay in the intensive care unit, time of discharge from hospital, and surgical intervention. Descriptive analyses were performed for all variables. Survivors and non-survivors were compared for baseline and treatment data.

RESULTS:

Ninety-five infants were identified (44% female). Of these, 77% were left-sided hernias, 52% were diagnosed prenatally, and 6.4% had concurrent malformations. The 28-day mortality rate was 21.1%, and the 1 year mortality rate was 22.1%. Of the 21 non-survivors, nine died within the first 24 h, and 10 were sufficiently stabilised to undergo surgery. A statistically significant difference was observed between survivors and non-survivors regarding APGAR score at 1 and 5 min., prenatal diagnosis, body length at birth, and delivery at OUH.

CONCLUSIONS:

Our outcome results were comparable to published data from other centres, including centres using ECMO.

KEYWORDS:

Congenital diaphragmatic hernia; Extra corporeal membrane oxygenation; Infants; Outcomes; Retrospective cohort studyPMID: 32381070 PMCID: PMC7204041 DOI: 10.1186/s12887-020-02072-2Free PMC Article

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