medigraphic.com
ISSN 1560-4381 (Print)

2021, Number 2

<< Back Next >>

Correo Científico Médico 2021; 25 (2)

Mortality prognostic factors of congenital diaphragmatic hernia at the Eastern Regional Neonatal Surgery Center

Quintero NW, Cordovés AY, Núñez ML, Reynaldo CR, Ortiz EK

Language: Spanish
References: 20
Page:
PDF size: 310.54 Kb.


ABSTRACT

Introduction: Congenital diaphragmatic hernia is a defect of the formation and the closure of the diaphragm, which allows abdominal organs to move into the chest cavity. This causes lung hypoplasia and the development of pulmonary hypertension.
Objective: To evaluate some prognostic factors associated to the mortality in newborns with congenital diaphragmatic hernia.
Method: A retrospective study was carried out at the Eastern Regional Neonatal Surgery Center, from January 2000 to December 2018. The universe was constituted by 35 patients, who were studied according to clinical and paraclinical variables.
Results: Prenatal diagnosis was carried out in 22.8% of the patients. In 65.7% of them, Apgar at one minute was poor and it didn't improve notably within five minutes in 25.7%. Immediate intubation was done in 22.8% of the neonates and transfer was assessed as faulty in 25.7%. 48.6% of the patients was intervened in the first 24 hours. Mortality was 34.3%, related to oxygenation index (OI), which was higher than 40 in 34.2%, and ventilation index (VI) that was higher than 1.000 in 31.4% of patients.
Conclusions: Survival was good. Even with conventional measures of ventilatory and pharmacological supports, severe pulmonary hypertension is the main cause of death. Transfer conditions to the regional center are still inadequate, therefore, the proper functioning of the integral protocol for perinatal care will allow an improvement of these results.


REFERENCES

  1. Masoud M, Bashirnejad S, Malekian A, Aramesh MR, Aletayeb MH. Seasonality, Epidemiology and Outcome of Congenital Diaphragmatic Hernia in South West of Iran. J Neonatal Surg. 2017[citado 25/08/2020]; 6(2):28. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538594/

  2. Snoek KG, Capolupo I, Braguglia A, Lucia Aite L, Rosmalen J, Valfrè L, et al. Neurodevelopmental Outcome in High-Risk Congenital Diaphragmatic Hernia Patients: An Appeal for International Standardization. Neonatology.2016[citado 25/08/2020];109(1):14–21 Disponible en: https://www.karger.com/Article/Pdf/438978

  3. Hedrick HL, Adzick NS. Congenital diaphragmatic hernia in the neonate. Neoreviews. 2015[citado 25/08/2020]; 16(12):680–92. Disponible en: https://www.uptodate.com/contents/congenital-diaphragmatic-hernia-in-the-neonate

  4. Quintero Nicó W. Morbilidad y mortalidad de la Cirugía Neonatal en Holguín. 1990-2006. [Tesis]. Holguín: Hospital Pediátrico Universitario Provincial “Octavio de la Concepción de la Pedraja”; 2007.

  5. Sperling JD, Sparks TN, Berger VK, Farrell JA, Gosnell K, Keller RL, et al. Prenatal Diagnosis of Congenital Diaphragmatic Hernia: Does Laterality Predict Perinatal Outcomes? Am J Perinatol. 2018[citado 15/07/2020]; 35(10): 919-924. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033692

  6. Basta AM, Lusk LA, Keller RL, Filly RA. Fetal Stomach Position Predicts Neonatal Outcomes in Isolated Left-Sided Congenital Diaphragmatic Hernia. Fetal Diagn Ther. 2016[citado 25/07/2019];39(4):248-255. Disponible en: https://www.karger.com/Article/Pdf/440649

  7. Tracey O, Chan S, Kieffer S, Delisle MF. Fetal Outcomes of Prenatally Diagnosed Congenital Diaphragmatic Hernia: Nine Years of Clinical Experience in a Canadian Tertiary Hospital . Obstetrics. 2017[citado 25/08/2019];38(1):17-22. Disponible en: https://www.jogc.com/article/S1701-2163(15)00007-9/fulltext

  8. Yunes A, Luco M, Pattillo JC. Early versus late surgical correction in congenital diaphragmatic hernia. Medwave.2017[citado 25/08/2020]; 17(9):7081 Disponible en:https://www.medwave.cl/link.cgi/English/Updates/Epistemonikos/7081

  9. Ruano R, Javadian P, Kailin JA, Maskatia SA, Shamshirsaz A, Cass DL, et al. Congenital heart anomaly in newborns with congenital diaphragmatic hernia: a single-center experience. Ultrasound Obstet Gynecol. 2015[citado 25/08/2020]; 45(6): 683-688. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.14648

  10. Burgos CM, Hammarqvist-Vejde J, Frenckner B, Conner P. Differences in Outcomes in Prenatally Diagnosed Congenital Diaphragmatic Hernia Compared to Postnatal Detection: A Single-Center Experience Fetal Diagn Ther. 2016[citado 25/08/2020];39(4):241-247.Disponible en: https://www.karger.com/Article/PDF/439303

  11. Chandrasekharan PK, Rawat M, Madappa R, Rothstein D, Lakshminrusimha S. Congenital Diaphragmatic hernia–a review. Matern Health Neonatol Perinatol.2017[citado 18/05/2020]; 3:6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356475/pdf/40748

  12. Pramod S, Puligandla M, Skarsgard M, Offringa M, Adatia I, Baird R, et al. Diagnosis and management of congenital diaphragmatic hernia: a clinical practice guideline CMAJ.2018[citado 25/08/2020];190(4):103-112. Disponible en: https://www.cmaj.ca/content/190/4/E103.short

  13. Grivell RM, Andersen CH, Dodd JM. Prenatal interventions for congenital diaphragmatic hernia for improving outcomes. Cochrane Database Syst Rev. 2015[citado 25/08/2020];27(11).Disponible en: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008925.pub2/full.

  14. Schultz H, Daniel S, Schwartz D. Predicting outcomes in congenital diaphragmatic hernia. J Pediatr Surg. 2014[citado 25/08/2020]; 49(6):886-889. Disponible en: https://www.jogc.com/article/S1701-2163(15)00007-9/pdf

  15. Vasanth H, Kumar S. Current Concepts in the Management of Congenital Diaphragmatic Hernia in Infants.Indian J Surg. 2015[citado 25/08/2020]; 77(4):313-321 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688266/pdf/12262

  16. Daodu O, Brindle ME. Predicting outcomes in congenital diaphragmatic hernia. Seminars in Pediatric Surgery. 2017[citado 25/08/2020]; 26(3): 136-139. Disponible en: https://reader.elsevier.com/reader/sd/pii/S1055858617300495

  17. Moscatelli A, Pezzato S, Lista G, MD, Petrucci L, MD, Buratti S, MD, Castagnola E, et al. Diaphragmatic Hernia: Role of Ductal Patency and Lung Recruitment. Pediatrics. 2016[citado 25/08/2020]; 138: 5-7. Disponible en: http://pediatrics.aappublications.org/content/pediatrics/138/5/e20161034

  18. Takahashi S, Sago H, Kanamori Y, Hayakawa M, Okuyama H, Inamura N, et al. Prognostic factors of congenital diaphragmatic hernia accompanied by cardiovascular malformation. Pediatr Int. 2013[citado 25/08/2020]; 55(4):492-497. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1111/ped.12104

  19. Morais C , Rocha G, Filipa F, Éden P, Fragoso AC, Guimarães H. Predictors of prognosis in neonates with congenital diaphragmatic hernia: experience of 12 years. J Pediatric Neonatal Individ Med .2017[citado 25/08/2020];6(1). Disponible en: http://www.jpnim.com/index.php/jpnim/article/viewFile/060126/414

  20. Morini F, Lally K, Lally PA, Crisafulli RM, Capolupo I, Bagolan P. Treatment strategies for congenital Diaphragmatic hernia: change sometimes comes Bearing gifts .Front Pediatr. 2017[citado 25/08/2020]; 5:195. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603669/pdf/fped-05-00195.pdf




2020     |     www.medigraphic.com