Right- versus left-sided congenital diaphragmatic hernia

• Verfasst von: Schaible, Thomas [VerfasserIn]
• Verfasst von: Kohl, Thomas [VerfasserIn]
• Verfasst von: Reinshagen, Konrad [VerfasserIn]
• Verfasst von: Brade, Joachim [VerfasserIn]
• Verfasst von: Neff, Wolfgang [VerfasserIn]
• Verfasst von: Stressig, Rüdiger [VerfasserIn]
• Verfasst von: Büsing, Karen-Anett [VerfasserIn]
• Titel: Right- versus left-sided congenital diaphragmatic hernia
• Titelzusatz: postnatal outcome at a specialized tertiary care center
• Verf.angabe: Thomas Schaible, MD; Thomas Kohl, MD; Konrad Reinshagen, MD; Joachim Brade, PhD; K. Wolfgang Neff, MD;MD; Rudiger Stressig, MD; Karen A. Büsing, MD
• E-Jahr: 2012
• Jahr: Jan 2012
• Umfang: 6 S.
• Fussnoten: Gesehen am 10.08.2018
• Titel Quelle: Enthalten in: Pediatric critical care medicine
• Ort Quelle: Philadelphia, Pa. : Lippincott Williams & Wilkins, 2000
• Jahr Quelle: 2012
• Band/Heft Quelle: 13(2012), 1, Seite 66-71
• ISSN Quelle: 1947-3893
• DOI: doi:10.1097/PCC.0b013e3182192aa9
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Erscheint auch als : Druck-Ausgabe: Schaible, Thomas, 1960 - : Right- versus left-sided congenital diaphragmatic hernia. - 2012
• Sach-SW: chronic lung disease
• Sach-SW: extracorporeal membrane oxygenation
• Sach-SW: prognosis
• Sach-SW: right-sided congenital diaphragmatic hernia
• Sach-SW: risk factors
• Sach-SW: survival
• K10plus-PPN: 1578462150

Abstract

Objective: 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., Design: Retrospective tertiary care center study with a matched-pair analysis of all fetuses that were treated for congenital diaphragmatic hernia between 2004 and 2009., Setting: A specialized tertiary care center for fetuses with congenital diaphragmatic hernia., Patients: 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., Interventions: None., Measurements and Main Results: 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., Conclusions: 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., (C)2012The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies