TY - JOUR
T1 - Trends in the treatment and outcome of congenital diaphragmatic hernia over the last decade
AU - Garriboli, Massimo
AU - Duess, Johannes Wolfgang
AU - Ruttenstock, Elke
AU - Bishay, Mark
AU - Eaton, Simon
AU - De Coppi, Paolo
AU - Puri, Prem
AU - Höllwarth, Michael E.
AU - Pierro, Agostino
PY - 2012/12
Y1 - 2012/12
N2 - Purpose: Congenital diaphragmatic hernia (CDH) remains a challenging and life-threatening congenital anomaly. The aim was to evaluate whether treatment and survival has changed during the last decade. Methods: We retrospectively analysed all consecutive infants with CDH referred to two European tertiary paediatric surgical centres over 11 years (January 1999 to December 2009). Minimum follow-up was 1 year. χ2 test for trend was used to evaluate significance. Results: There were 234 infants. There was no significant variation over time in the proportion of infants receiving high frequency oscillatory ventilation (HFOV) (p = 0.89), inhaled nitric oxide (iNO) (p = 0.90) or extracorporeal membrane oxygenation (ECMO) (p = 0.22). 205 infants (88 %) were stabilised and underwent surgical repair; of these, 186 (79 %) survived after surgery. Over time there was a significant increase in the proportion of infants undergoing surgical repair (p = 0.018) without a concomitant significant improvement in survival (p = 0.099). Conclusion: This multicentre analysis indicates that the survival rate of infants with CDH referred to two European paediatric surgical centres is high (79 %). The use of HFOV, iNO and ECMO has not changed in recent years. We observed a significant increase in the proportion of infants who undergo surgery but this has not resulted in a significant increase in the overall survival rate.
AB - Purpose: Congenital diaphragmatic hernia (CDH) remains a challenging and life-threatening congenital anomaly. The aim was to evaluate whether treatment and survival has changed during the last decade. Methods: We retrospectively analysed all consecutive infants with CDH referred to two European tertiary paediatric surgical centres over 11 years (January 1999 to December 2009). Minimum follow-up was 1 year. χ2 test for trend was used to evaluate significance. Results: There were 234 infants. There was no significant variation over time in the proportion of infants receiving high frequency oscillatory ventilation (HFOV) (p = 0.89), inhaled nitric oxide (iNO) (p = 0.90) or extracorporeal membrane oxygenation (ECMO) (p = 0.22). 205 infants (88 %) were stabilised and underwent surgical repair; of these, 186 (79 %) survived after surgery. Over time there was a significant increase in the proportion of infants undergoing surgical repair (p = 0.018) without a concomitant significant improvement in survival (p = 0.099). Conclusion: This multicentre analysis indicates that the survival rate of infants with CDH referred to two European paediatric surgical centres is high (79 %). The use of HFOV, iNO and ECMO has not changed in recent years. We observed a significant increase in the proportion of infants who undergo surgery but this has not resulted in a significant increase in the overall survival rate.
KW - Congenital diaphragmatic hernia
KW - Extracorporeal membrane oxygenation
KW - High-frequency oscillatory ventilation
KW - Inhaled nitric oxide
KW - Neonatal surgery
UR - https://www.scopus.com/pages/publications/84877630040
U2 - 10.1007/s00383-012-3184-5
DO - 10.1007/s00383-012-3184-5
M3 - Article
C2 - 23089981
AN - SCOPUS:84877630040
SN - 0179-0358
VL - 28
SP - 1177
EP - 1181
JO - Pediatric Surgery International
JF - Pediatric Surgery International
IS - 12
ER -