Does a highest pre-ductal O-2 saturation < 85% predict non-survival for congenital diaphragmatic hernia?

作者：Yoder B A^*; Lally P A; Lally K P

来源：Journal of Perinatology, 2012, 32(12): 947-952.

DOI：10.1038/jp.2012.18

• congenital diaphragmatic hernia
• survival
• prediction
• oxygen saturation

Objective: To analyze operative repair, extracorporeal membrane oxygenation (ECMO) and survival rates based on highest pre-ductal oxygen saturation (Pre-O(2)SAT) in a large infant cohort reported to Congenital Diaphragmatic Hernia Study Group Registry between 2000 and 2010.
Study Design: Analyzed data included gestational age, birth weight, defect side and size, repair, ECMO use, survival and highest reported PaO2 and Pre-O(2)SAT in first 24 h of life. We excluded 614 infants due to severe anomaly. Pre-O(2)SAT data were available for 1672 infants.
Result: Among infants with highest Pre-O(2)SAT value <85%, survival (24/105 = 23%) and repair (55/105 = 52%) rates were significantly decreased compared with infants with higher values. Survival increased to 44% for infants with highest Pre-O(2)SAT<85% who underwent operative repair. Of these, 83% (20/24) required ECMO support compared with 15% (144/961) of survivors with Pre-O(2)SAT>99% (P<0.001). The lowest reported Pre-O(2)SAT with survival was 32% and for survival without ECMO was 52%.
Conclusion: A reported highest Pre-O(2)SAT<85% in the first 24 h of life was not uniformly fatal; but survival of infants with Pre-O(2)SAT<85% was associated with high ECMO use and prolonged hospitalization. Journal of Perinatology (2012) 32, 947-952; doi:10.1038/jp.2012.18; published online 1 March 2012

• 出版日期2012-12