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Multicenter Study
. 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

Julia Wynn  1 , Usha Krishnan, Gudrun Aspelund, Yuan Zhang, Jimmy Duong, Charles J H Stolar, Eunice Hahn, John Pietsch, Dai Chung, Donald Moore, Eric Austin, George Mychaliska, Robert Gajarski, Yen-Lim Foong, Erik Michelfelder, Douglas Potolka, Brian Bucher, Brad Warner, Mark Grady, Ken Azarow, Scott E Fletcher, Shelby Kutty, Jeff Delaney, Timothy Crombleholme, Erika Rosenzweig, Wendy Chung, Marc S Arkovitz
Affiliations
Multicenter Study

Outcomes of congenital diaphragmatic hernia in the modern era of management

Julia Wynn et al. J Pediatr. 2013 Jul.

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.

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