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Congenital diaphragmatic hernia: A local experience
H Khawahur1, A Kattan, S Al-Alaiyan
1Department of Pediatrics, Section of Neonatology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Annals of Saudi Medicine
|February 6, 2007
Summary
Congenital diaphragmatic hernia (CDH) in infants is associated with a 43% mortality rate. High ventilatory support, respiratory acidosis, and persistent pulmonary hypertension of the newborn (PPHN) are key risk factors for mortality in CDH patients.
Area of Science:
- Pediatric Surgery
- Neonatology
- Critical Care Medicine
Background:
- Congenital diaphragmatic hernia (CDH) is a serious condition affecting newborns.
- Understanding clinical and surgical aspects is crucial for improving outcomes.
Purpose of the Study:
- To review clinical and surgical aspects of congenital diaphragmatic hernia (CDH).
- To identify risk factors impacting survival in infants with CDH.
Main Methods:
- Retrospective review of 33 infants with CDH admitted to NICU from 1989-1996.
- Analysis of patient demographics, clinical data, and outcomes.
Main Results:
- Overall mortality rate for CDH was 43% (14 out of 33 infants).
- High mortality associated with pH < 7.3, PaCO2 > 45 mm Hg, peak inspiratory pressure > 25 cm, and PPHN.
- Delayed surgical repair (>48 hours) showed a trend towards higher survival.
Conclusions:
- Severe respiratory acidosis and PPHN are significant predictors of mortality in CDH.
- Aggressive ventilatory support is linked to increased mortality risk.
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