The presence of a hernia sac in isolated congenital diaphragmatic hernia is associated with less disease severity: A retrospective cohort study
| Autor: | Daryl Schantz, Gabrielle Derraugh, Matthew Levesque, Richard Keijzer, Anna C. Shawyer, Suyin A. Lum Min, Melanie Morris |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Nitric Oxide Severity of Illness Index Primary outcome Disease severity Recurrence Vasoactive Administration Inhalation Humans Medicine Child Retrospective Studies business.industry Infant Newborn Oxygen Inhalation Therapy Infant Congenital diaphragmatic hernia Retrospective cohort study Free Radical Scavengers General Medicine Prognosis medicine.disease Respiration Artificial Surgery Pediatrics Perinatology and Child Health Oxygen dependency Breathing Female Hernia sac Hernias Diaphragmatic Congenital business |
| Zdroj: | Journal of Pediatric Surgery. 54:899-902 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2019.01.016 |
| Popis: | Introduction We aimed to determine if the presence of a hernia sac in neonates with isolated congenital diaphragmatic hernia (CDH) was associated with better clinical outcomes. Methods We performed a retrospective cohort study of infants with isolated CDH from 1991 to 2015. Primary outcome measures were oxygen-dependence and mortality at 28 days. Secondary measures were: inhaled nitric oxide use, vasoactive medication use, ventilator support, and recurrence rates. Results Seventy-one patients met the inclusion criteria: 14 patients (19.7%) had a hernia sac, and 57 patients (80.3%) did not. Mortality did not differ between the 2 groups [0 of 14 versus 3 of 57 (5.3%) (p = 1.000)]. Hernia sac patients had similar oxygen-dependence after 28 days [1 of 14 (7.1%) versus 14 of 57 (24.6%) (p = 0.273)]. Hernia sac children required less iNO (0.64 ± 2.41 vs. 6.35 ± 12.2 days, p = 0.002), vasoactive medications (2.79 ± 3.07 vs. 5.36 ± 5.52, p = 0.027), and time on ventilation (7.62 ± 6.12 vs. 15.9 ± 19.2, p = 0.010). Hernia sac children had similar recurrence rates within 2 years [0 of 14 versus 7 of 57 (12.3%) (p = 0.331)]. Conclusion The presence of a hernia sac was not associated with lower rates of oxygen dependency or death at 28 days but was associated with decreased inhaled nitric oxide, vasoactive medication, and ventilator use. Level of evidence III |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect