1. Association between initial ventilation mode and hospital outcomes for severe congenital diaphragmatic hernia.
- Author
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Wild KT, Mathew L, Ades AM, Rintoul NE, Soorikian L, Matthews K, Lee S, Van Hoose KT, Kesler E, Flohr S, Bostwick A, Reynolds T, Hedrick HL, and Foglia EE
- Subjects
- Humans, Infant, Newborn, Female, Male, Blood Gas Analysis, Treatment Outcome, Carbon Dioxide blood, Severity of Illness Index, Hernias, Diaphragmatic, Congenital therapy, Hernias, Diaphragmatic, Congenital mortality, High-Frequency Ventilation methods, Extracorporeal Membrane Oxygenation methods, Respiration, Artificial, Length of Stay
- Abstract
Objective: To determine the association between initial delivery room (DR) ventilator (conventional mechanical ventilation [CMV] versus high frequency oscillatory ventilation [HFOV] and hospital outcomes for infants with severe congenital diaphragmatic hernia (CDH)., Study Design: Quasi-experimental design before/after introducing a clinical protocol promoting HFOV. The primary outcome was first blood gas parameters. Secondary outcomes included serial blood gas assessments, ECMO, survival, duration of ventilation, and length of hospitalization., Results: First pH and CO
2 were more favorable in the HFOV group (n = 75) than CMV group (n = 85), median (interquartile range (IQR)) pH 7.18 (7.03, 7.24) vs. 7.05 (6.93, 7.17), adjusted p-value < 0.001; median CO2 62.0 (46.0, 82.0) vs 85.9 (59.0, 103.0), adjusted p-value < 0.001. ECMO, survival, duration of ventilation, and length of hospitalization did not differ between groups in adjusted analysis., Conclusion: Among infants with severe CDH, initial DR HFOV was associated with improved early gas exchange with no adverse differences in hospital outcomes., (© 2024. The Author(s).)- Published
- 2024
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