先天性膈疝婴儿的程序性处置:对生存率的影响
Background/Purpose:
In 2006, we introduced a new protocol for congenital diaphragmatic hernia (CDH) management featuring nitric oxide in the delivery room, gentle ventilation, lower criteria for extracorporeal membrane oxygenation (ECMO), and appropriately timed operative repair on ECMO. Our goals were to assess outcomes after institution of this protocol and to compare results with historical controls.
Methods:
Charts were reviewed of all newborns admitted to a large metropolitan children's hospital from 2002 to 2009 with a diagnosis of CDH. Data were recorded regarding delivery, ECMO, operative repair, length of stay, comorbidities/anomalies, complications, and survival. Postprotocol outcomes were compared to those from the preprotocol era and to data from the international CDH Registry.
Results:
Comparison of the protocolized group (n=43) to the historical group (n=51) revealed no significant differences in gestational age, birth weight, Apgar scores, or comorbidities. New treatment strategies substantially improved survival to discharge (67% preprotocol, 88% postprotocol; P=.015). Among ECMO patients, survival increased to 82% (20% preprotocol; P=.002).
Conclusions:
Our new protocol significantly improved survival to discharge for newborns with CDH. Institution of such a protocol is valuable in improving outcomes for patients with CDH and merits consideration for widespread adoption.
上一篇: 右心室收缩期与舒张期比率:先天性膈疝的一种简单的预后标志物
下一篇: 定向新生儿超声心动图在新生儿重症监护病房中的应用:实践指南与培训建议:美国超声心动学会(ASE)、欧洲超声心动学会(EAE)及欧洲小儿心脏科医师协会(AEPC)联合撰写组
来源: Eclips
- 您可能感兴趣的文章
-