J Perinatol

. 2020 Nov 11. doi: 10.1038/s41372-020-00833-6. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/33177680/

Prognosis of conventional vs. high-frequency ventilation for congenital diaphragmatic hernia: a retrospective cohort study

Makiko Fuyuki ^1 2, Noriaki Usui ³, Tomoaki Taguchi ⁴, Masahiro Hayakawa ⁵, Kouji Masumoto ⁶, Yutaka Kanamori ⁷, Shoichiro Amari ⁸, Masaya Yamoto ⁹, Naoto Urushihara ⁹, Noboru Inamura ¹⁰, Akiko Yokoi ¹¹, Manabu Okawada ¹², Tadaharu Okazaki ^12 13, Katsuaki Toyoshima ¹⁴, Taizou Furukawa ¹⁵, Keita Terui ¹⁶, Satoko Ohfuji ¹⁷, Yuko Tazuke ¹⁸, Keiichi Uchida ¹⁹, Hiroomi Okuyama ¹⁸, Japanese Congenital Diaphragmatic Hernia Study GroupCollaborators, Affiliations expand

• PMID: 33177680
• DOI: 10.1038/s41372-020-00833-6

Abstract

Objective: To determine the appropriate initial ventilatory mode for neonatal congenital diaphragmatic hernia (CDH) by comparing patient prognosis following conventional mechanical ventilation (CMV) versus high-frequency oscillatory ventilation (HFO).

Study design: This multicenter retrospective cohort study was performed at 15 participating hospitals in Japan between 2011 and 2016. The 328 eligible CDH infants were classified into CMV (n = 78) and HFO groups (n = 250) to compare mortality and incidence of bronchopulmonary dysplasia (BPD). Propensity score matching was applied to reduce confounding by indication.

Result: While crude mortality was significantly higher in the HFO than the CMV group, adjusted odds ratio (OR) did not show significant difference in mortality between groups (OR of HFO group: 0.98, 95% confidence interval (CI): 0.57-1.67). Adjusted OR of BPD incidence showed no significant difference between groups (OR of HFO group: 1.66, 95%CI: 0.50-5.49).

Conclusion: Initial ventilatory mode in CDH patients, whether CMV or HFO, does not affect prognosis.