[Congenital diaphragmatic hernia: evaluation of two ways of management].
OBJECTIVE
The aim of this study was to analyze the treatment and evolution of congenital diaphragmatic hernia in the last 16 years, distinguishing two ways of management, and to look for parameters that can predict the evolution.


METHODS
Between 1978 and 1994, 29 cases of congenital diaphragmatic hernia were treated in our NICU. During the first period (1978-1988) 17 cases (group 1) were treated after birth as a surgical emergency. In the second period (1989-1994), preoperative stabilization was performed before surgery (12 cases, group 2). Two cases of group 2 were excluded because of the association of other malformations that were the cause of death.


RESULTS
Both groups were similar in gestational age, birth weight and Apgar score at 5 minutes. Overall mortality was 48.1% (47.0% in group 1 and 50.0% in group 2). No infants with PaCO2 greater than 40 mmHg and OI greater than 40 or VEI over 1,000 survived.


CONCLUSIONS
Despite preoperative stabilization, there is no difference in the mortality rate of the two groups. With congenital diaphragmatic hernia, as with other entities of low incidence, collaborative studies are needed to obtain enough cases to analyze the results more precisely.
Gibert Agulló
A
A
Sección de Neonatología, Unidad Integrada de Pediatría Hospital Clínic-Hospital Sant Joan de Déu-Casa Maternitat, Universidad de Barcelona.
Moreno Hernando
J
J
Balagué Galito
E
E
Iriondo Sanz
M
M
Lizarraga Vidaurreta
I
I
Riverola de Veciana
A
A
Krauel Vidal
J
J
D005260:Female; D006548:Hernia, Diaphragmatic / Q000401:mortality / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate