title: Short-term outcomes and medical and surgical interventions in infants with congenital diaphragmatic hernia.
abstract: OBJECTIVE
  The aim of this study is to characterize medical and surgical therapies and short-term outcomes in infants with congenital diaphragmatic hernia (CDH).
  
  
  METHODS
  Retrospective analysis of CDH infants admitted to 27 children's hospitals submitting data to Children's Hospital Neonatal Database (CHND) from 2010 to 2013, stratified by gestational age, birth weight, and survival.
  
  
  RESULTS
  A total of 572 infants were identified, 508 (89%) born ≥ 34 weeks' gestation and ≥ 2 kg. More mature infants had higher APGAR scores, shorter duration of mechanical ventilation, and were more likely to receive extracorporeal membrane oxygenation (ECMO). Overall, mortality for the cohort was 29%, with mortality lower in infants born ≥ 34 weeks' gestation and ≥ 2 kg (26 vs. 50%, p < 0.01). Nonsurvivors were more likely to receive treatment with high-frequency oscillatory ventilation (HFOV), vasopressors, pulmonary vasodilators, and ECMO, and to have associated major congenital anomalies than survivors. In hospital morbidity and complications were relatively uncommon among survivors.
  
  
  CONCLUSIONS
  Infants with CDH have a high risk of morbidity and mortality, and for preterm infants with CDH those risks are amplified. Patterns of respiratory and circulatory support appeared to be different for survivors. In addition to established data registries, this consortium of regional neonatal intensive care units provides a new collaborative effort to describe short-term outcomes for infants referred with CDH.
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Theresa R
authors.initials: TR
authors.lastname: Grover
authors.affiliation: Ann and Robert H. Lurie Children's Hospital and Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Karna
authors.initials: K
authors.lastname: Murthy
authors.affiliation: Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Beverly
authors.initials: B
authors.lastname: Brozanski
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Jason
authors.initials: J
authors.lastname: Gien
authors.affiliation: Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Natalie
authors.initials: N
authors.lastname: Rintoul
authors.affiliation: Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Keene
authors.affiliation: Washington University, St. Louis, Missouri.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Najaf
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Louis
authors.initials: L
authors.lastname: Chicoine
authors.affiliation: Ann and Robert H. Lurie Children's Hospital and Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Porta
authors.affiliation: Children's Hospital Association, Overland Park, Kansas.
authors.forename: Isabella
authors.initials: I
authors.lastname: Zaniletti
authors.affiliation: Children's Mercy Hospital and University of Missouri, Kansas City, Missouri.
authors.forename: Eugenia K
authors.initials: EK
authors.lastname: Pallotto
mesh_terms: D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005865:Gestational Age; D065630:Hernias, Diaphragmatic, Congenital / Q000401:mortality* / Q000628:therapy*; D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D014481:United States