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Oct 25, 2018

7th Congress of the European Academy of Paediatric Societies

0090 - OUTCOMES AND MANAGEMENT OF INFANTS BORN WITH CONGENITAL DIAPHRAGMATIC HERNIA: A RETROSPECTIVE STUDY IN A TERTIARY NEONATAL UNIT

neonatology

congenital diaphragmatic hernia

intensive care

Abstract

Abstract

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Keywords

neonatology

congenital diaphragmatic hernia

intensive care

Abstract

Background: Congenital diaphragmatic hernia (CDH) occurs in approximately 3/10,000 lives births typically causing respiratory distress and acute pulmonary hypertension. 20-30% of infants die in the neonatal period with reports of >50% mortality when associated with other defects, particularly of the cardiovascular system. Aims: To study the outcomes at discharge of infants with CDH treated at Cambridge University Hospitals (CUH). To review cardiorespiratory management strategies used at CUH with available electronic patient records. Methods: All infants with CDH treated at our institute between Jan 2007-Dec 2016 were identified from our neonatal database and their discharge summaries and, if applicable, electronic records reviewed. Results: During the period of study, 52 infants with CDH were treated, outcomes of which can be seen in Table 1. Mortality was not significantly higher in those born with concomitant cardiovascular malformation, however, rates of requirement for additional specialist services were significantly higher in those born with heart defects (Figure 1) (p=0.0017 Fisher’s Exact Test). 12 of the 52 cases of CDH had electronic patient records available. Outcomes in this subgroup were comparable to the whole cohort with a mortality rate of 25% and on review of the cardiorespiratory management used, an aggressive strategy to diagnose and treat pulmonary hypertension was used. (Figure 2) Conclusion: The outcomes in our cohort appear in line with the best outcomes published for both isolated CDH and cases associated with cardiovascular malformation. Management focussing on pulmonary hypertension may therefore be beneficial and this approach is supported by the CDH EURO Consensus guidelines.

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© Copyright 2019 Morressier GmbH.
All rights reserved.