Document Detail


Improvement of survival in infants with congenital diaphragmatic hernia in recent years: effect of ECMO availability and associated factors.
MedLine Citation:
PMID:  20512342     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Survival of patients with congenital diaphragmatic hernia (CDH) depends both on non-modifiable congenital conditions and on modifiable pre and postnatal management. ECMO improves survival up to 80% in neonates with CDH in the best ECMO centers worldwide. The first Neonatal ECMO Program in Chile was started in our University in 2003. Our objective is to determine the impact of a Neonatal ECMO Program in a level III NICU on newborns with CDH. METHODS: Data of all newborns with CDH admitted to our NICU was separated into two groups: pre ECMO (1996-2003) and ECMO (2003-2007). Crude and adjusted odds ratios for 24 months survival were estimated by logistic regression. RESULTS: Data of 46 newborns with CDH was analysed, 20 in the pre ECMO and 26 in the ECMO period. Patient characteristics were similar in both groups; however, 24-month survival increased significantly from 25% (5/20) in the pre ECMO period to 77% (20/26) in the ECMO period (P = 0.001). Adjusted odds ratios for 24-month survival were 26.98 for OI <or= 40, 7.58 for 5 min Apgar >or= 7 and 17.5 for ECMO availability. CONCLUSIONS: The establishment of an ECMO program was associated with a significant increase in long-term survival for infants with CDH.
Authors:
Javier Kattan; Loreto Godoy; Alejandro Zavala; Miriam Faunes; Pedro Becker; Alberto Estay; Jorge Fabres; Paulina Toso; Soledad Urzúa; Jorge Becker; Jaime Cerda; Alvaro González
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2010-05-29
Journal Detail:
Title:  Pediatric surgery international     Volume:  26     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  671-6     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Lira 85, Piso 5, Santiago, Chile. kattan@med.puc.cl
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MeSH Terms
Descriptor/Qualifier:
Chile
Extracorporeal Membrane Oxygenation*
Female
Hernia, Diaphragmatic / congenital*,  mortality,  therapy*
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Logistic Models
Male
Odds Ratio
Program Evaluation
Retrospective Studies
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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