title: A simplified formula using early blood gas analysis can predict survival outcomes and the requirements for extracorporeal membrane oxygenation in congenital diaphragmatic hernia.
abstract: The aims of this study were to investigate whether early arterial blood gas analysis (ABGA) could define the severity of disease in infants with congenital diaphragmatic hernia (CDH). We conducted a retrospective study over a 21-yr period of infants diagnosed with CDH. Outcomes were defined as death before discharge, and extracorporeal membrane oxygenation requirements (ECMO) or death. A total 114 infants were included in this study. We investigated whether simplified prediction formula [PO2-PCO2] values at 0, 4, 8, and 12 hr after birth were associated with mortality, and ECMO or death. The area under curve (AUC) of receiver operating characteristic curve was used to determine the optimum ABGA values for predicting outcomes. The value of [PO2-PCO2] at birth was the best predictor of mortality (AUC 0.803, P < 0.001) and at 4 hr after birth was the most reliable predictor of ECMO or death (AUC 0.777, P < 0.001). The value of [PO2-PCO2] from ABGA early period after birth can reliably predict outcomes in infants with CDH.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
authors.forename: Byong Sop
authors.initials: BS
authors.lastname: Lee
authors.forename: Gina
authors.initials: G
authors.lastname: Lim
authors.forename: Yong-Sung
authors.initials: YS
authors.lastname: Choi
authors.forename: Ellen Ai-Rhan
authors.initials: EA
authors.lastname: Kim
authors.forename: Ki-Soo
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000465:Algorithms; D019540:Area Under Curve; D001784:Blood Gas Analysis; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006548:Hernia, Diaphragmatic / Q000401:mortality / Q000503:physiopathology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Congenital Diaphragmatic Hernia; Extracorporeal Membrane Oxygenation; Infant, Newborn; Mortality