title: Congenital diaphragmatic hernia - a Belgrade single center experience.
abstract: OBJECTIVE
  Though the outcome for children with congenital diaphragmal hernia (CDH) is improving, management of seriously compromised respiratory and cardiovascular function remains a great challenge. The aim of this study was to review a tertiary center experience in treating children with CDH.
  
  
  METHODS
  Retrospective observational study from January 2005 to December 2014.
  
  
  METHODS
  Neonatal Intensive Care Unit (NICU) of University Children Hospital (UCH), Belgrade, Serbia.
  
  
  METHODS
  Children with CDH.
  
  
  RESULTS
  The CDH was diagnosed prenatally in 23% patients. An overall survival rate was 62%. Among those patients who underwent surgical repair 29 (90%) survived. There was statistically significant difference in survival rate between operated patients and total examined population (P=0.020). Prenatally diagnosed neonates with CDH had significantly lower survival rate comparing to those who were postnatally diagnosed (20% vs. 75%; P=0.002). Fatal outcome was more frequent in patients with small birth weight comparing to those with normal birth weight (67% vs. 30%; P=0.046).
  
  
  CONCLUSIONS
  Our center survival rate for CDH is in accordance with other reported studies. Based on our experience there are potential points for further improvement. First, further increase of prenatal detection, planning for delivery, and coordinated transfer to tertiary institution, in order to avoid transfer of near death patients. Second, preoperative management in the NICU. This could be done by more uniform implementation of current consensual guidelines in monitoring, mechanical ventilation and circulatory support of these delicate patients, together with rationale use of newer therapeutic resources.
authors.forename: Jasna
authors.initials: J
authors.lastname: Kalanj
authors.forename: Petar
authors.identifier: http://orcid.org/0000-0003-2020-5591
authors.initials: P
authors.lastname: Salevic
authors.forename: Snezana
authors.initials: S
authors.lastname: Rsovac
authors.forename: Biljana
authors.initials: B
authors.lastname: Medjo
authors.forename: Sanja Sindjic
authors.initials: SS
authors.lastname: Antunovic
authors.forename: Dusica
authors.initials: D
authors.lastname: Simic
mesh_terms: D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D015996:Survival Rate; D016216:Ultrasonography, Prenatal