Best pre-ductal PaO2 prior to extracorporeal membrane oxygenation as predictor of mortality in patients with congenital diaphragmatic hernia: a retrospective ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-09-06

AUTHORS

Keita Terui, Taizo Furukawa, Kouji Nagata, Masahiro Hayakawa, Hiroomi Okuyama, Shoichiro Amari, Akiko Yokoi, Kouji Masumoto, Masaya Yamoto, Tadaharu Okazaki, Noboru Inamura, Katsuaki Toyoshima, Keiichi Uchida, Manabu Okawada, Yasunori Sato, Noriaki Usui

ABSTRACT

PurposePredicting lethal pulmonary hypoplasia in infants with congenital diaphragmatic hernia (CDH) before extracorporeal membrane oxygenation (ECMO) initiation is difficult. This study aimed to predict lethal pulmonary hypoplasia in patients with CDH prior to ECMO.MethodsThis was a multicenter cohort study involving neonates prenatally diagnosed with isolated unilateral CDH (born 2006–2020). Patients who required ECMO due to respiratory insufficiency were included in this study. Patients who underwent ECMO due to transient disorders were excluded from analysis. Blood gas analysis data within 24 h of birth were compared between survivors and non-survivors. Predictive abilities were assessed for factors with significant differences.ResultsOverall, 34 patients were included (18 survivors and 16 non-survivors). The best pre-ductal PaO2 was significantly lower in non-survivors than in survivors (50.4 [IQR 30.3–64.5] vs. 67.5 [IQR 52.4–103.2] mmHg, respectively; p = 0.047). A cutoff PaO2 of 42.9 mmHg had a sensitivity, specificity, and positive predictive value of 50.0%, 94.4%, and 88.9%, respectively, to predict mortality.ConclusionThe best PaO2 within 24 h after birth predicted mortality following ECMO initiation. This should be shared to families and caregivers to optimize the best interests of the infants with CDH. More... »

PAGES

1667-1673

Journal

TITLE

Pediatric Surgery International

ISSUE

12

VOLUME

37

Author Affiliations

  • Department of Pediatric Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, 260-8677, Chiba, Japan
  • Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
  • Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
  • Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
  • Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe, Japan
  • Department of Pediatric Surgery, Tsukuba University, Tsukuba, Japan
  • Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan
  • Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan
  • Department of Pediatrics, Kinki University, Higashiosaka, Japan
  • Department of Neonatology, Kanagawa Children’s Medical Center, Kanagawa, Japan
  • Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
  • Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
  • Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
  • Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, Osaka, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00383-021-04995-y

    DOI

    http://dx.doi.org/10.1007/s00383-021-04995-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1140911403

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34487208


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