Document Detail

A clinical analysis of prognostic parameters of survival in children with congenital diaphragmatic hernia.
MedLine Citation:
PMID:  16418956     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Congenital diaphragmatic hernia (CDH) still has a high mortality because of accompanying lung hypoplasia and persistent pulmonary hypertension. Although prognostic parameters based on perinatal measurements have been proposed, our ability to accurately predict the surgical results remains insufficient. METHODS: We treated 55 infants with CDH from 1981 to 2004. Among them, 46 patients presented respiratory distress within the first 24 hours of life. Results of surgical treatment in the 46 infants were retrospectively correlated with gender, birth weight, gestational age at diagnosis, laterality, cardiac anomalies, diaphragmatic defect area, contents of herniated viscera, and the great vessel diameters measured by echocardiography. RESULTS: Out of 46 CDH neonates, 27 (58.7 %) survived and 19 (41.3 %) died aged 3 to 17 days. Non survivors had a significantly larger diaphragmatic defect and more frequent liver herniation. Out of possible predictive parameters studied, an index of the main pulmonary artery (cross-sectional area/diaphragmatic defect area ratio) most closely correlated with the surgical outcomes. CONCLUSIONS: The postoperative prognosis of CDH infants does not depend only on pulmonary hypoplasia, but also on other factors including the magnitude of abdominal visceral herniation. In this series of patients, the most reliable prognostic predictor was a clinical index reflecting the degree of both pulmonary hypoplasia and diaphragmatic maldevelopment.
S Fumino; T Shimotake; Y Kume; T Tsuda; S Aoi; O Kimura; E Deguchi; N Iwai
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie     Volume:  15     ISSN:  0939-7248     ISO Abbreviation:  Eur J Pediatr Surg     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-18     Completed Date:  2006-03-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9105263     Medline TA:  Eur J Pediatr Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  399-403     Citation Subset:  IM    
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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MeSH Terms
Hernia, Diaphragmatic / congenital*,  mortality*,  pathology
Infant, Newborn
Pulmonary Artery / pathology

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