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J Pediatr. 2013 Jul;163(1):114-9.e1. doi: 10.1016/j.jpeds.2012.12.036. Epub 2013 Jan 30.

Outcomes of congenital diaphragmatic hernia in the modern era of management.

Author information

1
Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Abstract

OBJECTIVE:

To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH).

STUDY DESIGN:

A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently. Degree of PH and survival were tested for association with clinical variables using Fischer exact test, χ(2), and regression analysis.

RESULTS:

Two hundred twenty patients met inclusion criteria. Worse PH measured at 1 month of life was associated with higher mortality. Other factors associated with mortality were need for extracorporeal membrane oxygenation, patients inborn at the treating center, and patients with a prenatal diagnosis of CDH. Interestingly, patients with right sided CDH did not have worse outcomes.

CONCLUSIONS:

Severity of PH is associated with mortality in CDH. Other factors associated with mortality were birth weight, gestational age at birth, inborn status, and need for extracorporeal membrane oxygenation.

PMID:
23375362
PMCID:
PMC3692597
DOI:
10.1016/j.jpeds.2012.12.036
[Indexed for MEDLINE]
Free PMC Article

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