Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center
To systematically investigate the impact of the location of the defect in congenital diaphragmatic hernia on neonatal mortality and morbidity with a special focus on survival at discharge, extracorporeal membrane oxygenation requirement, and the development of chronic lung disease. Retrospective ter...
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| Veröffentlicht in: | Pediatric critical care medicine 2012-01, Vol.13 (1), p.66-71 |
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| creator | Schaible, Thomas Kohl, Thomas Reinshagen, Konrad Brade, Joachim Neff, K Wolfgang Stressig, Rüdiger Büsing, Karen A |
| description | To systematically investigate the impact of the location of the defect in congenital diaphragmatic hernia on neonatal mortality and morbidity with a special focus on survival at discharge, extracorporeal membrane oxygenation requirement, and the development of chronic lung disease.
Retrospective tertiary care center study with a matched-pair analysis of all fetuses that were treated for congenital diaphragmatic hernia between 2004 and 2009.
A specialized tertiary care center for fetuses with congenital diaphragmatic hernia.
Complete sets of data were available for 106 patients with congenital diaphragmatic hernia. For 17 of 18 infants with right-sided congenital diaphragmatic hernia we were able to allocate infants with left-sided congenital diaphragmatic hernia with no relevant difference in previously described prognostic factors, such as pulmonary hypoplasia and liver herniation.
None.
There was a strong trend toward better survival in infants with right-sided congenital diaphragmatic hernia than with left-sided congenital diaphragmatic hernia (94% vs. 70%; p = .07). More neonates with left-sided congenital diaphragmatic hernia died of severe pulmonary hypertension despite extracorporeal membrane oxygenation. Fewer neonates with right-sided congenital diaphragmatic hernia died, yet higher degrees of pulmonary hypoplasia and oxygen requirement were observed despite extracorporeal membrane oxygenation.
In congenital diaphragmatic hernia, the location of the defect has a substantial impact on postnatal survival and the development of chronic lung disease. In left-sided congenital diaphragmatic hernia, pulmonary hypertension resistant to therapeutic management, including extracorporeal membrane oxygenation, is more common and is associated with a higher rate of neonatal demise. Right-sided congenital diaphragmatic hernia infants have an increased benefit from extracorporeal membrane oxygenation but the better survival entails a higher rate of chronic lung disease. |
| doi_str_mv | 10.1097/PCC.0b013e3182192aa9 |
| format | Article |
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Retrospective tertiary care center study with a matched-pair analysis of all fetuses that were treated for congenital diaphragmatic hernia between 2004 and 2009.
A specialized tertiary care center for fetuses with congenital diaphragmatic hernia.
Complete sets of data were available for 106 patients with congenital diaphragmatic hernia. For 17 of 18 infants with right-sided congenital diaphragmatic hernia we were able to allocate infants with left-sided congenital diaphragmatic hernia with no relevant difference in previously described prognostic factors, such as pulmonary hypoplasia and liver herniation.
None.
There was a strong trend toward better survival in infants with right-sided congenital diaphragmatic hernia than with left-sided congenital diaphragmatic hernia (94% vs. 70%; p = .07). More neonates with left-sided congenital diaphragmatic hernia died of severe pulmonary hypertension despite extracorporeal membrane oxygenation. Fewer neonates with right-sided congenital diaphragmatic hernia died, yet higher degrees of pulmonary hypoplasia and oxygen requirement were observed despite extracorporeal membrane oxygenation.
In congenital diaphragmatic hernia, the location of the defect has a substantial impact on postnatal survival and the development of chronic lung disease. In left-sided congenital diaphragmatic hernia, pulmonary hypertension resistant to therapeutic management, including extracorporeal membrane oxygenation, is more common and is associated with a higher rate of neonatal demise. Right-sided congenital diaphragmatic hernia infants have an increased benefit from extracorporeal membrane oxygenation but the better survival entails a higher rate of chronic lung disease.</description><identifier>ISSN: 1529-7535</identifier><identifier>DOI: 10.1097/PCC.0b013e3182192aa9</identifier><identifier>PMID: 21478793</identifier><language>eng</language><publisher>United States</publisher><subject>Case-Control Studies ; Extracorporeal Membrane Oxygenation - methods ; Female ; Fetal Diseases - diagnosis ; Follow-Up Studies ; Hernia, Diaphragmatic - mortality ; Hernia, Diaphragmatic - pathology ; Hernia, Diaphragmatic - surgery ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging - methods ; Male ; Postoperative Complications - mortality ; Postoperative Complications - therapy ; Pregnancy ; Prenatal Diagnosis - methods ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Survival Analysis ; Thoracoscopy - adverse effects ; Thoracoscopy - methods ; Treatment Outcome</subject><ispartof>Pediatric critical care medicine, 2012-01, Vol.13 (1), p.66-71</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c255t-6691ede75f9386db679c34db96e1561c3a2c554676764956a27430f11f2419653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21478793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaible, Thomas</creatorcontrib><creatorcontrib>Kohl, Thomas</creatorcontrib><creatorcontrib>Reinshagen, Konrad</creatorcontrib><creatorcontrib>Brade, Joachim</creatorcontrib><creatorcontrib>Neff, K Wolfgang</creatorcontrib><creatorcontrib>Stressig, Rüdiger</creatorcontrib><creatorcontrib>Büsing, Karen A</creatorcontrib><title>Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center</title><title>Pediatric critical care medicine</title><addtitle>Pediatr Crit Care Med</addtitle><description>To systematically investigate the impact of the location of the defect in congenital diaphragmatic hernia on neonatal mortality and morbidity with a special focus on survival at discharge, extracorporeal membrane oxygenation requirement, and the development of chronic lung disease.
Retrospective tertiary care center study with a matched-pair analysis of all fetuses that were treated for congenital diaphragmatic hernia between 2004 and 2009.
A specialized tertiary care center for fetuses with congenital diaphragmatic hernia.
Complete sets of data were available for 106 patients with congenital diaphragmatic hernia. For 17 of 18 infants with right-sided congenital diaphragmatic hernia we were able to allocate infants with left-sided congenital diaphragmatic hernia with no relevant difference in previously described prognostic factors, such as pulmonary hypoplasia and liver herniation.
None.
There was a strong trend toward better survival in infants with right-sided congenital diaphragmatic hernia than with left-sided congenital diaphragmatic hernia (94% vs. 70%; p = .07). More neonates with left-sided congenital diaphragmatic hernia died of severe pulmonary hypertension despite extracorporeal membrane oxygenation. Fewer neonates with right-sided congenital diaphragmatic hernia died, yet higher degrees of pulmonary hypoplasia and oxygen requirement were observed despite extracorporeal membrane oxygenation.
In congenital diaphragmatic hernia, the location of the defect has a substantial impact on postnatal survival and the development of chronic lung disease. In left-sided congenital diaphragmatic hernia, pulmonary hypertension resistant to therapeutic management, including extracorporeal membrane oxygenation, is more common and is associated with a higher rate of neonatal demise. Right-sided congenital diaphragmatic hernia infants have an increased benefit from extracorporeal membrane oxygenation but the better survival entails a higher rate of chronic lung disease.</description><subject>Case-Control Studies</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Female</subject><subject>Fetal Diseases - diagnosis</subject><subject>Follow-Up Studies</subject><subject>Hernia, Diaphragmatic - mortality</subject><subject>Hernia, Diaphragmatic - pathology</subject><subject>Hernia, Diaphragmatic - surgery</subject><subject>Hernias, Diaphragmatic, Congenital</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - therapy</subject><subject>Pregnancy</subject><subject>Prenatal Diagnosis - methods</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Survival Analysis</subject><subject>Thoracoscopy - adverse effects</subject><subject>Thoracoscopy - methods</subject><subject>Treatment Outcome</subject><issn>1529-7535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1LAzEQhnNQbK3-A5HcPG3dJJuk8SbFLxAU0fMyzc62kf1qkhX015ti9SBzGJh53_l4CDlj-ZzlRl8-L5fzfJUzgYItODMcwByQKZPcZFoKOSHHIbznOTOq0EdkwlmhF9qIKdm-uPUmZvQDfRgDbbCOWXAVVtT23Ro7F6GhlYNh42HdQnSWbtB3Dq7o0IfYwa7fj9H2LVKIFGgY0Dpo3FeaEdFHB_6TWvBILXapcEIOa2gCnu7zjLzd3rwu77PHp7uH5fVjZrmUMVPKMKxQy9qIhapWShsrimplFDKpmBXArZSF0ikKIxVwXYi8ZqzmRXpTihm5-Jk7-H47Yohl64LFpoEO-zGUhiUzXxiWlMWP0vo-BI91OXjXprNLlpc7vmXiW_7nm2zn-wXjqsXqz_QLV3wD10d6IA</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Schaible, Thomas</creator><creator>Kohl, Thomas</creator><creator>Reinshagen, Konrad</creator><creator>Brade, Joachim</creator><creator>Neff, K Wolfgang</creator><creator>Stressig, Rüdiger</creator><creator>Büsing, Karen A</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201201</creationdate><title>Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center</title><author>Schaible, Thomas ; Kohl, Thomas ; Reinshagen, Konrad ; Brade, Joachim ; Neff, K Wolfgang ; Stressig, Rüdiger ; Büsing, Karen A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c255t-6691ede75f9386db679c34db96e1561c3a2c554676764956a27430f11f2419653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Case-Control Studies</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Female</topic><topic>Fetal Diseases - diagnosis</topic><topic>Follow-Up Studies</topic><topic>Hernia, Diaphragmatic - mortality</topic><topic>Hernia, Diaphragmatic - pathology</topic><topic>Hernia, Diaphragmatic - surgery</topic><topic>Hernias, Diaphragmatic, Congenital</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - therapy</topic><topic>Pregnancy</topic><topic>Prenatal Diagnosis - methods</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Survival Analysis</topic><topic>Thoracoscopy - adverse effects</topic><topic>Thoracoscopy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaible, Thomas</creatorcontrib><creatorcontrib>Kohl, Thomas</creatorcontrib><creatorcontrib>Reinshagen, Konrad</creatorcontrib><creatorcontrib>Brade, Joachim</creatorcontrib><creatorcontrib>Neff, K Wolfgang</creatorcontrib><creatorcontrib>Stressig, Rüdiger</creatorcontrib><creatorcontrib>Büsing, Karen A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaible, Thomas</au><au>Kohl, Thomas</au><au>Reinshagen, Konrad</au><au>Brade, Joachim</au><au>Neff, K Wolfgang</au><au>Stressig, Rüdiger</au><au>Büsing, Karen A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center</atitle><jtitle>Pediatric critical care medicine</jtitle><addtitle>Pediatr Crit Care Med</addtitle><date>2012-01</date><risdate>2012</risdate><volume>13</volume><issue>1</issue><spage>66</spage><epage>71</epage><pages>66-71</pages><issn>1529-7535</issn><abstract>To systematically investigate the impact of the location of the defect in congenital diaphragmatic hernia on neonatal mortality and morbidity with a special focus on survival at discharge, extracorporeal membrane oxygenation requirement, and the development of chronic lung disease.
Retrospective tertiary care center study with a matched-pair analysis of all fetuses that were treated for congenital diaphragmatic hernia between 2004 and 2009.
A specialized tertiary care center for fetuses with congenital diaphragmatic hernia.
Complete sets of data were available for 106 patients with congenital diaphragmatic hernia. For 17 of 18 infants with right-sided congenital diaphragmatic hernia we were able to allocate infants with left-sided congenital diaphragmatic hernia with no relevant difference in previously described prognostic factors, such as pulmonary hypoplasia and liver herniation.
None.
There was a strong trend toward better survival in infants with right-sided congenital diaphragmatic hernia than with left-sided congenital diaphragmatic hernia (94% vs. 70%; p = .07). More neonates with left-sided congenital diaphragmatic hernia died of severe pulmonary hypertension despite extracorporeal membrane oxygenation. Fewer neonates with right-sided congenital diaphragmatic hernia died, yet higher degrees of pulmonary hypoplasia and oxygen requirement were observed despite extracorporeal membrane oxygenation.
In congenital diaphragmatic hernia, the location of the defect has a substantial impact on postnatal survival and the development of chronic lung disease. In left-sided congenital diaphragmatic hernia, pulmonary hypertension resistant to therapeutic management, including extracorporeal membrane oxygenation, is more common and is associated with a higher rate of neonatal demise. Right-sided congenital diaphragmatic hernia infants have an increased benefit from extracorporeal membrane oxygenation but the better survival entails a higher rate of chronic lung disease.</abstract><cop>United States</cop><pmid>21478793</pmid><doi>10.1097/PCC.0b013e3182192aa9</doi><tpages>6</tpages></addata></record> |
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| subjects | Case-Control Studies Extracorporeal Membrane Oxygenation - methods Female Fetal Diseases - diagnosis Follow-Up Studies Hernia, Diaphragmatic - mortality Hernia, Diaphragmatic - pathology Hernia, Diaphragmatic - surgery Hernias, Diaphragmatic, Congenital Humans Infant, Newborn Magnetic Resonance Imaging - methods Male Postoperative Complications - mortality Postoperative Complications - therapy Pregnancy Prenatal Diagnosis - methods Retrospective Studies Risk Assessment Severity of Illness Index Survival Analysis Thoracoscopy - adverse effects Thoracoscopy - methods Treatment Outcome |
| title | Right- versus left-sided congenital diaphragmatic hernia: postnatal outcome at a specialized tertiary care center |
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