https://scholars.lib.ntu.edu.tw/handle/123456789/531085
標題: | Prognostic indicators of survival in infants with congenital diaphragmatic hernia | 作者: | HUNG-CHIEH CHOU Tang J.-R. HONG-SHIEE LAI PO-NIEN TSAO Yau K.-I.T. |
公開日期: | 2001 | 卷: | 100 | 期: | 3 | 起(迄)頁: | 173-175 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Purpose: This study sought to identify the factors predictive of the short-term outcome in infants with congenital diaphragmatic hernia (CDH). Methods: We retrospectively reviewed medical records from September 1985 to December 1998 for all infants born with CDH and managed at National Taiwan University Hospital (NTUH). Coexisting pathology and measures of respiratory function were analyzed to determine the prognostic factors. Results: A total of 32 infants with CDH were managed at NTUH over the past 13 years. The investigated factors associated with poor prognosis in CDH included congenital heart disease, chromosomal abnormality, pneumothorax, and preoperative parameters including arterial partial carbon dioxide pressure greater than 40 mmHg, arterial partial oxygen pressure less than 100 mmHg, alveolo-arterial partial oxygen pressure greater than 610 mmHg, and oxygen index (OI) greater than 0.4. Multiple logistic regression analyses indicated that only an OI greater than 0.4 and pneumothorax were significant indicators of poor prognosis. When the incidence of pneumothorax was compared between patients who received ventilation using a conventional mechanical ventilator or high-frequency oscillatory ventilator (HFOV), a trend toward a lower incidence of pneumothorax in those using HFOV for initial stabilization was found (p = 0.08). Conclusions: An OI greater than 0.4 before surgery and pneumothorax are poor prognostic indicators in infants with CDH. A high OI is reflective of the severity of pulmonary dysfunction in infants. Pneumothorax further compromises the dysfunction of a hypoplastic lung in infants with CDH. The results of this study show the importance of avoiding iatrogenic pneumothorax during management of infants with CDH. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0035003799&partnerID=40&md5=2da698daadca6ebac9a84ba7895b906a https://scholars.lib.ntu.edu.tw/handle/123456789/531085 |
ISSN: | 0929-6646 | SDG/關鍵字: | carbon dioxide; oxygen; arterial carbon dioxide tension; arterial oxygen tension; article; artificial ventilation; chromosome aberration; clinical article; congenital diaphragm hernia; congenital heart disease; controlled study; data analysis; disease severity; female; high frequency oscillation; high frequency ventilation; human; iatrogenic disease; incidence; infant; lung disease; lung hypoplasia; male; medical record; multiple regression; outcomes research; parameter; pathology; pneumothorax; prediction; preoperative period; prognosis; respiratory function; retrospective study; survival; time; university hospital; ventilator; Female; Hernia, Diaphragmatic; Humans; Infant, Newborn; Male; Pneumothorax; Prognosis; Retrospective Studies |
顯示於: | 醫學系 |
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