The predicting values of Pao2/Fio2 ratio in survival of neonates with Congenital Diaphragmatic Hernia
Iranian Journal of Pediatric Surgery,
Vol. 2 No. 2 (2016),
11 February 2017
Introduction: Respiratory failure is one of the most important related factors in morbidity and mortality of neonates with congenital diaphragmatic hernia (CDH). Determining indexes that could ultimately and perceivably predict the disease severity and its prognosis is crucial. This study aimed to evaluate the predictive value of Pao2/Fio2 ratio(P/F ratio) in neonates with CDH.
Materials and Methods: In this retrospective study, medical records of all neonates with CDH admitted to Alzahra (Isfahan, Iran) hospitalfrom 2005 to 2015 were checked. Thirty-five neonates with CDH were studied. Data collected were: gestational age, sex, weight, Pao2, Fio2 and clinical outcome.
Results: In this survey 24 neonates with CDH were studied. The mean P/F ratio in the survival group was 2.12 ±0.90 and in the non-survival group, 1.38± 0.48. According to these results the P/F ratio in the survival group was higher than the other group and this difference was statistically significant (P= 0.02). Based on the ROC curve, the specificity of P/F ratio in predicting survival is 72.2 percent and its sensitivity in predicting death is 80 percent.
Conclusion: P/F ratio is a useful index for predicting the outcome of neonates with CDH.
- Pao2/Fio2 ratio
- congenital diaphragmatic hernia
Basiewicz-Slaczka E, Wotoszczuk-Gebicka B, Yaqoub S, Kaminski A. The value of the oxygenation index in the prediction of postnatal outcome in neonates with congenital diaphragmatic hernia. Prelimainary report. Dev period med. 2015; 3(1): 283- 288.
Gentili A, De Rose R, Inannella E, Letizia Bacchi Reggiani M, lima M, Baroncini S. Is the Time Necessary to Obtain Preoperative Stabilization a Predictive Index of Outcome in Neonatal Congenital Diaphragmatic Hernia? IJP. 2012; volume 2012.
Michal Rygl K, Pycha Z, Stranak J, Melichar L, Krofta L, Tomasek J, Snajdau f. Congenital diaphragmatic hernia: onset of respiratory distress and size of the defect. Pediatr Surg Int. 2007; 23: 27–31.
Bilan N, Dastanji A, Behbahani Ghalegolab A. Validity of Spo2/Fio2 Ratio in Detection of Acute Lung Injury and Acute Respiratory Distress Syndrome. Int J Pediatr, 2015; 3(1-2); 429-434.
Gentili A, Pasini A, Iannella E, Landuzzi V, Lima M, Bacchi Reggiani M L & Baroncini S. Predictive outcome indexes in neonatal Congenital Diaphragmatic Hernia. J Matern Fetal Neonatal Med. 2015; 28(13): 1602- 1607.
Usui N, Kitano Y, Okuyama H, Saito M, Morikawa N, Takayasu H, et al. the reliability of the lung to thorax transverse area ratio as a predictive parameter in fetus with congenital diaphragmatic hernia. Ped surg int. 2011; 27(1): 39- 45.
Yeon Lee J, Kwan Jun J, Ho Lee J. Prenatal prediction of neonatal survival in cases diagnosed with congenital diaphragmatic hernia using abdomen-to-thorax ratio determined by ultrasonography. J. Obstet. Gynaecol. Res. 2014; 40( 9): 2037–2043.
Cruz-Martinez R, Hernandez-Andrade E, Moreno- Alvarez O, Done E, Deprest J,Gratacos E. Prognostic Value of Pulmonary Doppler to Predict Response to Tracheal Occlusion in Fetuses with Congenital Diaphragmatic Hernia. Fetal Diagn Ther. 2011; 29(1): 18-24.
Ju-MingWong J, Foong Loh T, Testoni D, GuanYeoJ Hui Mok Y and Hau Lee J. Epidemiology of pediatric acute respiratory distress syndrome in Singapore: risk factors and predictive respiratory indices for mortality. Front Pediatr. 2014;2:78.
Mann PC, Morriss FH JR, Klein JM. Prediction survival in infants with congenital diaphragmatic hernia based on stomach position, surgical timing, and oxygenation index. Amer J Perinatol. 2012; 29(5): 383- 390.
Yehya N, Sarvaes S, Thomas N J. Characterizing Degree of Lung Injury in Pediatric Acute Respiratory Distress Syndrome. Crit Care Med. 2015; 43(5): 937- 946.
Patry C, Hlen S, demiracka S, rainhard J, Majorok M, Brade J, et al. Adjunctive Therapies for Treatment of Severe Respiratory Failure in Newborns. Klin Padiatr 2015; 227: 28–32.
Bhadade R, DE Souza R, Harde M, Asgaonkar D, Tuplondhe N. Mortality Predictors of ARDS in Medical Intensive Care Unit of a Tertiary Care Centre in a Tropical Country . J Assoc Physicians India. 2015;63(11):16-22.
Edriss H, Whiting J, Yang Sh, Nugent K. Peak Pressures And PaO2/FiO2 Ratios On Day 2 Predict Outcomes In Patients On Mechanical Ventilators. Am J Med Sci. 2016; 351(6):638-41.
Morse Sh, Greor M, Shelton M M, Maguire D, Ashmeade T. A systematic review. The Utility of the Revised Version of the Score for Neonatal Acute Physiology Among Critically Ill Neonates. J Perinat Neonat Nurs. 2015; 29(4): 315- 344.
Sung Ko B, Ahn Shin, Soo Lim K, Young Kim W, Lee Y-S, Ho Lee J. Early failure of noninvasive ventilation in chronic obstructive pulmonary disease with acute hypercapnic respiratory failure. Intern Emerg Med. 2015;10:855–860
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