Diaphragmatic Hernia in Children Admitted to Pediatric Hospital during 10 Years from 2009-19 Diaphragmatic Hernia Status in Iranian Children
Iranian Journal of Pediatric Surgery,
Vol. 8 No. 1 (2022),
Introduction: Diaphragmatic hernia is a congenital anomaly with significant mortality even in the best centers of the world. Numerous risk factors have been identified in studies as predictors of patient outcome. The aim of this study was to determine the status of diaphragmatic hernia and related outcomes in children admitted to pediatric hospital.
Materials and Methods: Data of diaphragmatic hernia was extracted from patients’ records in Dr. Sheikh Hospital in Northeast of Iran who were admitted since 2009 till 2019. Demographic and birth information, disease diagnostic findings along with developmental defects or syndromes were recorded. In addition, more information about the patient and surgery was collected, including the length of the patient's stay in the intensive care unit (ICU), and the patient's condition before and after surgery. Also, data about recurrence of the disease, postoperative growth and development status of the child were gathered.
Results: Study included 153 patients, of whom 61.4% were male. Term gestational age, vaginal delivery, respiratory distress, and organ defects were seen in 81.7%, 54.9%, 91.5 %, and 24.2 % respectively. The overall hospital mortality of patients was 24.8%.The Apgar score of the live group was significantly higher than that of the deceased group. The length of ICU stay before surgery was significantly higher in the deceased group.Pco2 levels were significantly higher before and after surgery in the deceased group.HCo3 levels in the dead group were significantly higher than that of the living group.
Conclusion: The results of our study suggested that Apgar score and VBG (venous blood gas) status were probably related to patients' outcome.
- Diaphragmatic hernia
How to Cite
Hedrick HL, Adzick NS: Congenital diaphragmatic hernia in the neonate. UpToDate, Waltham, MA, 2020.
Longoni M, Pober BR, High FA: Congenital Diaphragmatic Hernia Overview. GeneReviews®[Internet]: University of Washington, Seattle, 2019.
Deprest J, Brady P, Nicolaides K, et al: Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial. Seminars in Fetal and Neonatal Medicine 2014:19(6): 338-348.
Burgos CM, Frenckner B: Addressing the hidden mortality in CDH: A population-based study. Journal of pediatric surgery 2017;52(4):522-5.
McGivern MR, Best KE, Rankin J, et al: Epidemiology of congenital diaphragmatic hernia in Europe: a register-based study. Archives of Disease in Childhood-Fetal and Neonatal Edition 2015;100(2):F137-F44.
Kamath BD, Fashaw L, Kinsella JP: Adrenal insufficiency in newborns with congenital diaphragmatic hernia. The Journal of pediatrics 2010;156(3):495-7.
Hedrick HL, Adzick NS: Congenital diaphragmatic hernia: Prenatal issues. UpToDate, Waltham, MA, 2020.
Tsao K, Allison N, Harting M, et al: Congenital Diaphragmatic Hernia in the Preterm Infant: A Report from the Congenital Diaphragmatic Hernia Study Group. Journal of Surgical Research 2010;158(2):198.
Colvin J, Bower C, Dickinson JE, et al: Outcomes of congenital diaphragmatic hernia: a population-based study in Western Australia. Pediatrics 2005;116(3):e356-e63.
Mah VK, Zamakhshary M, Mah DY, et al: Absolute vs relative improvements in congenital diaphragmatic hernia survival: what happened to “hidden mortality”. Journal of pediatric surgery 2009;44(5):877-82.
Menon SC, Tani LY, Weng HY, et al: Clinical characteristics and outcomes of patients with cardiac defects and congenital diaphragmatic hernia. The Journal of pediatrics 2013;162(1):114-9. e2.
Lusk LA, Wai KC, Moon-Grady AJ, et al: Persistence of pulmonary hypertension by echocardiography predicts short-term outcomes in congenital diaphragmatic hernia. The Journal of pediatrics 2015;166(2):251-6.
Nasr A, Langer JC: Influence of location of delivery on outcome in neonates with congenital diaphragmatic hernia. Journal of pediatric surgery 2011;46(5):814-6.
Patel MJ, Bell CS, Lally KP, et al: Lowest PaCO2 on the first day of life predicts mortality and morbidity among infants with congenital diaphragmatic hernia. Journal of Perinatology 2019;39(2):229-36.
Abbas PI, Cass DL, Olutoye OO, et al: Persistent hypercarbia after resuscitation is associated with increased mortality in congenital diaphragmatic hernia patients. Journal of pediatric surgery 2015;50(5):739-43.
Khmour AY, Konduri GG, Sato TT, et al: Role of admission gas exchange measurement in predicting congenital diaphragmatic hernia survival in the era of gentle ventilation. Journal of pediatric surgery 2014;49(8):1197-201.
Yoder B, Lally P, Lally K: Does a highest pre-ductal O 2 saturation< 85% predict non-survival for congenital diaphragmatic hernia? Journal of Perinatology 2012;32(12):947-52.
Lally KP, Lally PA, Lasky RE, et al: Defect size determines survival in infants with congenital diaphragmatic hernia. Pediatrics 2007;120(3):e651-7.
Putnam LR, Harting MT, Tsao K, et al: Congenital diaphragmatic hernia defect size and infant morbidity at discharge. Pediatrics 2016;138(5):e20162043.
Downard CD, Jaksic T, Garza JJ, et al: Analysis of an improved survival rate for congenital diaphragmatic hernia. Journal of pediatric surgery 2003;38(5):729-32.
Kays DW, Langham Jr MR, Ledbetter DJ, et al: Detrimental effects of standard medical therapy in congenital diaphragmatic hernia. Annals of surgery 1999;230(3):340.
Reicker CA, Hirschl RB, Schumacher R, et al: Effect of very delayed repair of congenital diaphragmatic hernia on survival and extracorporeal life support use. Surgery 1996;120(4):766-73.
Frenckner B, Ehren H, Granholm T, et al: Improved results in patients who have congenital diaphragmatic hernia using preoperative stabilization, extracorporeal membrane oxygenation, and delayed surgery. Journal of pediatric surgery 1997;32(8):1185-9.
Leeuwen L, Fitzgerald DA: Congenital diaphragmatic hernia. Journal of paediatrics and child health 2014;50(9):667-73.
Carmichael SL, Ma C, Lee HC, et al: Survival of infants with congenital diaphragmatic hernia in California: impact of hospital, clinical, and socio demographic factors. Journal of Perinatology 2020:1-9.
Shanmugam H, Brunelli L, Botto LD, et al: Epidemiology and prognosis of congenital diaphragmatic hernia: A population‐based cohort study in Utah. Birth Defects Research 2017;109(18):1451-9.
Dehdashtian M, Bashirnejad S, Malekian A, et al: Seasonality, Epidemiology and Outcome of Congenital Diaphragmatic Hernia in South West of Iran. Journal of Neonatal Surgery 2017;6(2).
Hinton CF, Siffel C, Correa A, et al: Survival disparities associated with congenital diaphragmatic hernia. Birth defects research 2017;109(11):816-23.
Grizelj R, Bojanić K, Vuković J, et al: Epidemiology and outcomes of congenital diaphragmatic hernia in Croatia: a population‐based study. Paediatric and perinatal epidemiology 2016;30(4):336-45.
- Abstract Viewed: 30 times
- PDF Downloaded: 62 times