Skip to main content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener Medizinische Wochenschrift 13-14/2022

06.10.2021 | original article

Congenital diaphragmatic hernia: a single-centre experience at Kepler University Hospital Linz

verfasst von: Anna Hofer, Gudrun Huber, Regina Greiner, Julia Pernegger, Reza Zahedi, Franz Hornath

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 13-14/2022

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Congenital diaphragmatic hernia (CDH) is found in about 1 of 3000 live births and is often complicated by pulmonary hypoplasia and alteration of the pulmonary arterial wall with resulting pulmonary hypertension. Since 2005, with the fusion of the children’s hospital and the maternity clinic of the Kepler University Hospital Linz, affected neonates have been treated according to a standard protocol at our perinatal centre. Some prenatally measured parameters have been used to predict mortality, e.g., observed-to-expected lung-to-head ratio or lung volume measurements by nuclear magnetic resonance imaging. We performed a retrospective chart review of 67 new-borns with CDH treated at our institution to detect any predictors of hospital mortality from parameters routinely collected within the first 24 h of life. The term “liver up” was identified as a predictor of hospital mortality; OR 9.2 (95% CI 1.9–51.1, p = 0.002, sensitivity 79%, specificity 71%). In addition, the need for application of high-frequency oscillatory ventilation during the first 24 h was associated with mortality; OR 44.4 (95% CI 6.3–412.1, p = 0.001, sensitivity 85.7%, specificity 88%).
Literatur
1.
Zurück zum Zitat Wynn J, Krishnan U, Aspelund G, Zhang Y, Duong J, Stolar CJ, et al. Outcomes of congenital diaphragmatic hernia in the modern era of management. J Pediatr. 2013;163(1):114–9. CrossRef Wynn J, Krishnan U, Aspelund G, Zhang Y, Duong J, Stolar CJ, et al. Outcomes of congenital diaphragmatic hernia in the modern era of management. J Pediatr. 2013;163(1):114–9. CrossRef
2.
Zurück zum Zitat Hedrick HL. Management of prenatally diagnosed congenital diaphragmatic hernia. Semin Pediatr Surg. 2013;22(1):37–43. CrossRef Hedrick HL. Management of prenatally diagnosed congenital diaphragmatic hernia. Semin Pediatr Surg. 2013;22(1):37–43. CrossRef
3.
Zurück zum Zitat Hutcheon JA, Butler B, Lisonkova S, Marquette GP, Mayer C, Skoll A, et al. Timing of delivery for pregnancies with congenital diaphragmatic hernia. BJOG. 2010;117:1658–62. CrossRef Hutcheon JA, Butler B, Lisonkova S, Marquette GP, Mayer C, Skoll A, et al. Timing of delivery for pregnancies with congenital diaphragmatic hernia. BJOG. 2010;117:1658–62. CrossRef
4.
Zurück zum Zitat Odibo AO, Najaf T, Vachharajani A, Warner B, Mathur A, Warner BW. Predictors of the need for extracorporeal membrane oxygenation and survival in congenital diaphragmatic hernia: a center’s 10-year experience. Prenat Diagn. 2010;30:518–21. PubMed Odibo AO, Najaf T, Vachharajani A, Warner B, Mathur A, Warner BW. Predictors of the need for extracorporeal membrane oxygenation and survival in congenital diaphragmatic hernia: a center’s 10-year experience. Prenat Diagn. 2010;30:518–21. PubMed
5.
Zurück zum Zitat Safavi A, Lin Y, Skarsgard ED. Perinatal management of congenital diaphragmatic hernia: when and how should babies be delivered? Results from the Canadian Pediatric Surgery Network. J Pediatr Surg. 2010;45:2334–9. CrossRef Safavi A, Lin Y, Skarsgard ED. Perinatal management of congenital diaphragmatic hernia: when and how should babies be delivered? Results from the Canadian Pediatric Surgery Network. J Pediatr Surg. 2010;45:2334–9. CrossRef
6.
Zurück zum Zitat Beaumier CK, Beres AL, Puligandla PS, Skarsgard ED, Canadian Pediatric Surgery Network. Clinical characteristics and outcomes of patients with right congenital diaphragmatic hernia: a population-based study. J Pediatr Surg. 2015;50:731–3. CrossRef Beaumier CK, Beres AL, Puligandla PS, Skarsgard ED, Canadian Pediatric Surgery Network. Clinical characteristics and outcomes of patients with right congenital diaphragmatic hernia: a population-based study. J Pediatr Surg. 2015;50:731–3. CrossRef
7.
Zurück zum Zitat Harting MT, Lally KP. The congenital diaphragmatic hernia study group registry update. Semin Fetal Neonatal Med. 2014;19:370–5. CrossRef Harting MT, Lally KP. The congenital diaphragmatic hernia study group registry update. Semin Fetal Neonatal Med. 2014;19:370–5. CrossRef
8.
Zurück zum Zitat Metkus AP, Filly RA, Stringer MD, Harrison MR, Adzick NS. Sonographic predictors of survival in fetal diaphragmatic hernia. J Pediatr Surg. 1996;31(1):148–51. CrossRef Metkus AP, Filly RA, Stringer MD, Harrison MR, Adzick NS. Sonographic predictors of survival in fetal diaphragmatic hernia. J Pediatr Surg. 1996;31(1):148–51. CrossRef
9.
Zurück zum Zitat Heling KS, Wauer RR, Hammer H, Bollmann R, Chaoui R. Reliability of the lung-to-head ratio in predicting outcome and neonatal ventilation parameters in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol. 2005;25(2):112–8. CrossRef Heling KS, Wauer RR, Hammer H, Bollmann R, Chaoui R. Reliability of the lung-to-head ratio in predicting outcome and neonatal ventilation parameters in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol. 2005;25(2):112–8. CrossRef
10.
Zurück zum Zitat Ba’ath ME, Jesudason EC, Losty PD. How useful is the lung-to-head ratio in predicting outcome in the fetus with congenital diaphragmatic hernia? A systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2007;30(6):897–906. CrossRef Ba’ath ME, Jesudason EC, Losty PD. How useful is the lung-to-head ratio in predicting outcome in the fetus with congenital diaphragmatic hernia? A systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2007;30(6):897–906. CrossRef
11.
Zurück zum Zitat Russo FM, Eastwood MP, Keijzer R, Al-Maary J, Toelen J, Van Mieghem T, et al. Lung size and liver herniation predict need for extracorporeal membrane oxygenation but not pulmonary hypertension in isolated congenital diaphragmatic hernia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;49(6):704–13. CrossRef Russo FM, Eastwood MP, Keijzer R, Al-Maary J, Toelen J, Van Mieghem T, et al. Lung size and liver herniation predict need for extracorporeal membrane oxygenation but not pulmonary hypertension in isolated congenital diaphragmatic hernia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;49(6):704–13. CrossRef
12.
Zurück zum Zitat Kastenholz KE, Weis M, Hagelstein C, Weiss C, Kehl S, Schaible T, et al. Correlation of observed-to-expected MRI fetal lung volume and ultrasound lung-to-head ratio at different gestational times in fetuses with congenital diaphragmatic hernia. AJR Am J Roentgenol. 2016;206(4):856–66. CrossRef Kastenholz KE, Weis M, Hagelstein C, Weiss C, Kehl S, Schaible T, et al. Correlation of observed-to-expected MRI fetal lung volume and ultrasound lung-to-head ratio at different gestational times in fetuses with congenital diaphragmatic hernia. AJR Am J Roentgenol. 2016;206(4):856–66. CrossRef
13.
Zurück zum Zitat Harrison MR, Albanese CT, Hawgood SB, Farmer DL, Farrell JA, Sandberg PL, et al. Fetoscopic temporary tracheal occlusion by means of detachable balloon for congenital diaphragmatic hernia. Am J Obstet Gynecol. 2001;185(3):730–3. CrossRef Harrison MR, Albanese CT, Hawgood SB, Farmer DL, Farrell JA, Sandberg PL, et al. Fetoscopic temporary tracheal occlusion by means of detachable balloon for congenital diaphragmatic hernia. Am J Obstet Gynecol. 2001;185(3):730–3. CrossRef
14.
Zurück zum Zitat Harrison MR, Keller RL, Hawgood SB, Kitterman JA, Sandberg PL, Farmer DL, et al. A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med. 2003;349(20):1916–24. CrossRef Harrison MR, Keller RL, Hawgood SB, Kitterman JA, Sandberg PL, Farmer DL, et al. A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med. 2003;349(20):1916–24. CrossRef
15.
Zurück zum Zitat Jani JC, Nicolaides KH, Gratacós E, Valencia CM, Doné E, Martinez JM, et al. Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol. 2009;34:304–10. CrossRef Jani JC, Nicolaides KH, Gratacós E, Valencia CM, Doné E, Martinez JM, et al. Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol. 2009;34:304–10. CrossRef
16.
Zurück zum Zitat Van der Veeken L, Russo FM, De Catte L, Gratacos E, Benachi A, Ville Y, et al. Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia. Gynecol Surg. 2018;15(1):9. CrossRef Van der Veeken L, Russo FM, De Catte L, Gratacos E, Benachi A, Ville Y, et al. Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia. Gynecol Surg. 2018;15(1):9. CrossRef
17.
Zurück zum Zitat Snoek KG, Reiss IK, Greenough A, Capolupo I, Urlesberger B, Wessel L, et al. Standardized postnatal management of infants with congenital diaphragmatic hernia in europe: the CDH EURO consortium consensus—2015 update. Neonatology. 2016;110(1):66–74. CrossRef Snoek KG, Reiss IK, Greenough A, Capolupo I, Urlesberger B, Wessel L, et al. Standardized postnatal management of infants with congenital diaphragmatic hernia in europe: the CDH EURO consortium consensus—2015 update. Neonatology. 2016;110(1):66–74. CrossRef
18.
Zurück zum Zitat Snoek KG, Capolupo I, van Rosmalen J, et al. Conventional mechanical ventilation versus high-frequency oscillatory ventilation for congenital diaphragmatic hernia: a randomized clinical trial (The VICI-trial). Ann Surg. 2016;263:867–74. CrossRef Snoek KG, Capolupo I, van Rosmalen J, et al. Conventional mechanical ventilation versus high-frequency oscillatory ventilation for congenital diaphragmatic hernia: a randomized clinical trial (The VICI-trial). Ann Surg. 2016;263:867–74. CrossRef
19.
Zurück zum Zitat Wittekindt B, Doberschuetz N, Schmedding A, Theilen TM, Schloesser R, Gfroerer S, et al. Epidemiology and one-year follow-up of neonates with CDH-data from health insurance claims in Germany. Children (Basel). 2021;8(2):160. Wittekindt B, Doberschuetz N, Schmedding A, Theilen TM, Schloesser R, Gfroerer S, et al. Epidemiology and one-year follow-up of neonates with CDH-data from health insurance claims in Germany. Children (Basel). 2021;8(2):160.
20.
Zurück zum Zitat Chatterjee D, Ing RI, Gien J. Update on congenital diaphragmatic hernia. Anesth Analg. 2020;131(3):808–21. CrossRef Chatterjee D, Ing RI, Gien J. Update on congenital diaphragmatic hernia. Anesth Analg. 2020;131(3):808–21. CrossRef
21.
Zurück zum Zitat Ferguson DM, Gupta VS, Lally PA, Luco M, Tsao K, Lally KP, et al. Early, postnatal pulmonary hypertension severity predicts inpatient outcomes in congenital diaphragmatic hernia. Neonatology. 2021;118:147–54. CrossRef Ferguson DM, Gupta VS, Lally PA, Luco M, Tsao K, Lally KP, et al. Early, postnatal pulmonary hypertension severity predicts inpatient outcomes in congenital diaphragmatic hernia. Neonatology. 2021;118:147–54. CrossRef
22.
Zurück zum Zitat Lakshminrusimha S, Vali P. Congenital diaphragmatic hernia: 25 years of shared knowledge; what about survival? J Pediatr (Rio J). 2020;96(5):527–32. CrossRef Lakshminrusimha S, Vali P. Congenital diaphragmatic hernia: 25 years of shared knowledge; what about survival? J Pediatr (Rio J). 2020;96(5):527–32. CrossRef
23.
Zurück zum Zitat Seabrook RB, Grover TR, Rintoul N, Weems M, Keene S, Brozanski B, et al. Treatment of pulmonary hypertension during initial hospitalization in a multicenter cohort of infants with congenital diaphragmatic hernia (CDH). J Perinatol. 2021;41(4):803–13. CrossRef Seabrook RB, Grover TR, Rintoul N, Weems M, Keene S, Brozanski B, et al. Treatment of pulmonary hypertension during initial hospitalization in a multicenter cohort of infants with congenital diaphragmatic hernia (CDH). J Perinatol. 2021;41(4):803–13. CrossRef
24.
Zurück zum Zitat Didier RA, Oliver ER, Rungsiprakarn P, DeBari SE, Adams SE, Hedrick HL, et al. Decreased morbidity of ‘bowel-only’ left congenital diaphragmatic hernia patients: implications of prenatal ultrasound diagnosis for prenatal counseling and postnatal management. Ultrasound Obstet Gynecol. 2021; https://​doi.​org/​10.​1002/​uog.​23630. CrossRefPubMed Didier RA, Oliver ER, Rungsiprakarn P, DeBari SE, Adams SE, Hedrick HL, et al. Decreased morbidity of ‘bowel-only’ left congenital diaphragmatic hernia patients: implications of prenatal ultrasound diagnosis for prenatal counseling and postnatal management. Ultrasound Obstet Gynecol. 2021; https://​doi.​org/​10.​1002/​uog.​23630. CrossRefPubMed
25.
Zurück zum Zitat Vergote S, De Bie F, Bosteels J, Hedrick H, Duffy J, Power B et al. Study protocol: a core outcome set for perinatal interventions for congenital diaphragmatic hernia. Trials. 2021;22(1):158. CrossRef Vergote S, De Bie F, Bosteels J, Hedrick H, Duffy J, Power B et al. Study protocol: a core outcome set for perinatal interventions for congenital diaphragmatic hernia. Trials. 2021;22(1):158. CrossRef
Metadaten
Titel
Congenital diaphragmatic hernia: a single-centre experience at Kepler University Hospital Linz
verfasst von
Anna Hofer
Gudrun Huber
Regina Greiner
Julia Pernegger
Reza Zahedi
Franz Hornath
Publikationsdatum
06.10.2021
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 13-14/2022
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-021-00885-z

Weitere Artikel der Ausgabe 13-14/2022

Wiener Medizinische Wochenschrift 13-14/2022 Zur Ausgabe