Pediatr Surg Int
. 2022 Sep 23.
doi: 10.1007/s00383-022-05226-8. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36138323/
The efficacy of the postnatal nasogastric tube position as a prognostic marker of left-sided isolated congenital diaphragmatic hernia
Jun Kono 1, Kouji Nagata 2, Keita Terui 3, Shoichiro Amari 4, Katsuaki Toyoshima 5, Noboru Inamura 6, Yuhki Koike 7, Masaya Yamoto 8, Tadaharu Okazaki 9, Yuta Yazaki 10, Hiroomi Okuyama 11, Masahiro Hayakawa 12, Taizo Furukawa 13, Kouji Masumoto 14, Akiko Yokoi 15, Noriaki Usui 16, Tatsuro Tajiri 1
- PMID: 36138323
- DOI: 10.1007/s00383-022-05226-8
Purpose: The prenatal diagnosis of the stomach position in congenital diaphragmatic hernia (CDH) has been a reliable prognostic factor, but few studies have focused on the postnatal position. We therefore evaluated the significance of the nasogastric (NG) tube position just after birth.
Methods: The Japanese CDH Study Group database enrolled 1037 CDH neonates over 15 years. In our multicenter retrospective study, 464 cases of left-sided isolated CDH with prenatal diagnoses were divided into two groups: NG tube below the diaphragm (BD; n = 190) or above the diaphragm (AD; n = 274). The primary outcome was the 90-day survival rate, and the secondary outcomes were mechanical ventilation duration, hospitalization duration, and recurrence rate.
Results: The BD group had a significantly higher 90-day survival rate (98.4 vs. 89.4%, p < 0.001), shorter mechanical ventilation (11 vs. 19 days, p < 0.001), shorter hospitalization (38 vs. 59 days, p < 0.001), and lower recurrence rate (p = 0.002) than the AD group. A multivariate analysis showed that BD (adjusted odds ratio, 3.68; 95% confidence interval 1.02-13.30) was a favorable prognostic factor for the 90-day survival.
Conclusion: The assessment of the NG tube position revealed it to be a reliable prognostic factor of left-sided isolated CDH. Therefore, it should be included as a routine assessment.
Keywords: Congenital diaphragmatic hernia; Mortality; Nasogastric tube; Postnatal prognostic factor; Stomach position.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.