Does a highest pre-ductal O2 saturation <85% predict non-survival for congenital diaphragmatic hernia?

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.Analyzed data included gestational age, birth weight, defect side and size, repair, ECMO use, survival and highest reported PaO(2) 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.Among infants with highest Pre-O(2)SAT value85%, 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)SAT85% who underwent operative repair. Of these, 83% (20/24) required ECMO support compared with 15% (144/961) of survivors with Pre-O(2)SAT99% (P0.001). The lowest reported Pre-O(2)SAT with survival was 32% and for survival without ECMO was 52%.A reported highest Pre-O(2)SAT85% in the first 24 h of life was not uniformly fatal; but survival of infants with Pre-O(2)SAT85% was associated with high ECMO use and prolonged hospitalization.