TY - JOUR
T1 - Predictive value of oxygenation index for outcomes in left-sided congenital diaphragmatic hernia
AU - Bruns, Ashley S.
AU - Lau, Patricio E.
AU - Dhillon, Gurpreet S.
AU - Hagan, Joseph
AU - Kailin, Joshua A.
AU - Mallory, George B.
AU - Lohmann, Pablo
AU - Olutoye, Oluyinka O.
AU - Ruano, Rodrigo
AU - Fernandes, Caraciolo J.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background & objectives: Congenital Diaphragmatic Hernia (CDH) is associated with significant morbidity and mortality. This study compares the efficacy of the highest oxygenation index in the first 48 h (HiOI) versus current prenatal indices to predict survival and morbidity. Methods: Medical records of 50 prenatally diagnosed, isolated, left-sided CDH patients treated from January 2011 to April 2016 were reviewed. Data abstracted included HiOI, lung to head ratio (LHR), observed to expected total fetal lung volume (O/E TFLV), percent liver herniation (%LH), 6 month survival, respiratory support at discharge, ventilator days and length of stay. Data were analyzed using parametric and nonparametric tests and regression analyses as appropriate. Results: HiOI was associated with significantly increased LOS (p < 0.001), respiratory support at discharge (p < 0.001), greater ventilator days (p = 0.001) and higher odds of death (p = 0.004) with risk of death increasing by 5% for every one-unit increase in OI. HiOI was statistically a better predictor of LOS than O/E TFLV (p = 0.007) and %LH (p = 0.02). Conclusions: In isolated, left-sided CDH patients, HiOI is associated with higher mortality, greater length of stay, more ventilator days and increased respiratory support at discharge. HiOI is a better predictor of length of stay than O/E TFLV and %LH. Type of study: Retrospective Study Level of evidence: II
AB - Background & objectives: Congenital Diaphragmatic Hernia (CDH) is associated with significant morbidity and mortality. This study compares the efficacy of the highest oxygenation index in the first 48 h (HiOI) versus current prenatal indices to predict survival and morbidity. Methods: Medical records of 50 prenatally diagnosed, isolated, left-sided CDH patients treated from January 2011 to April 2016 were reviewed. Data abstracted included HiOI, lung to head ratio (LHR), observed to expected total fetal lung volume (O/E TFLV), percent liver herniation (%LH), 6 month survival, respiratory support at discharge, ventilator days and length of stay. Data were analyzed using parametric and nonparametric tests and regression analyses as appropriate. Results: HiOI was associated with significantly increased LOS (p < 0.001), respiratory support at discharge (p < 0.001), greater ventilator days (p = 0.001) and higher odds of death (p = 0.004) with risk of death increasing by 5% for every one-unit increase in OI. HiOI was statistically a better predictor of LOS than O/E TFLV (p = 0.007) and %LH (p = 0.02). Conclusions: In isolated, left-sided CDH patients, HiOI is associated with higher mortality, greater length of stay, more ventilator days and increased respiratory support at discharge. HiOI is a better predictor of length of stay than O/E TFLV and %LH. Type of study: Retrospective Study Level of evidence: II
KW - Congenital diaphragmatic hernia
KW - Hypoxemic respiratory failure
KW - Outcome
KW - Oxygenation index
KW - Pulmonary hypertension
KW - Survival
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U2 - 10.1016/j.jpedsurg.2017.12.023
DO - 10.1016/j.jpedsurg.2017.12.023
M3 - Article
C2 - 29428594
AN - SCOPUS:85041687829
VL - 53
SP - 1675
EP - 1680
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 9
ER -