Predictive outcome indexes in neonatal Congenital Diaphragmatic Hernia. (30th September 2014)

• Record Type: Journal Article
• Authors: Gentili, A.; Pasini, L.; Iannella, E.; Landuzzi, V.; Lima, M.; Bacchi Reggiani, M. L.; Baroncini, S.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 28:Number 13(2015)
• Page Start: 1602
• Page End: 1607
• Publication Date: 2014-09-30
• Subjects: Congenital diaphragmatic hernia -- neonate -- outcome predictive indexes -- prenatal findings -- postnatal scores -- survival; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : We examined the reliability of the main prenatal and postnatal prognosis-related indexes that can be used to evaluate congenital diaphragmatic hernia (CDH) outcome. Methods : Seventy-seven neonates with CDH were analyzed according to CDH prognosis-related factors, divided into prenatal findings, postnatal clinical values and postnatal predictive outcome scores applied at birth and within the first 12–24 h. The data are compared between two groups: survivors and non-survivors. Results : During prenatal age, major associated anomalies, intrathoracic stomach, diagnosis prior to 25 weeks of gestational age and lung-to-head ratio < 0.6 were statistically significant, demonstrating their greater incidence in non-survivors. The majority of postnatal values at PICU admission were found to be reliable in identifying the CDH outcome: paO2 /FiO2, oxygenation index, alveolar-arterial-O2 gradient, arterial-alveolar-O2 tension ratio, pH, mean blood pressure, body temperature. All the postnatal predictive outcome scores (Apgar 1′ and 5′, CDH-Study-Group equation, Score for Neonatal-Acute-Physiology II, SNAP-Perinatal-Extension II, Pediatric Risk of Mortality III and Wilford-Hall/Santa-Rosa formula) were statistically significant with more favorable values for prognosis in the survivors group. Conclusion : The chances of predicting CDH outcome are fairly high. During prenatal age, only a few findings may be obtained. Conversely, many postnatal indexes and scores can reliably predict such outcome.