Congenital Diaphragmatic Hernia Treated with HFO and Inhaled NO in a Neonatal Intensive Care Unit: A 12-Year Retrospective Analysis

Abstract

Objectives: To analyze the outcomes for patients with congenital diaphragmatic hernia. Methods: We retrospectively reviewed 26 patients with congenital diaphragmatic hernias who were admitted to China Medical University Hospital from January 1995 to December 2006. Congenital diaphragmatic hernia is identified by the presence of bowel loops in the lung field on chest radiography. The diagnosis of persistent pulmonary hypertension in newborns (PPHN) was determined by echocardiography. Results: Gestational ages were 37.4±1.7 wks (median: 38, range:33~40 wks) and birth weights were 2754±394 gm (median: 2800, range: 1450~3600 gm). The overall survival rate was 61.5% (16/26). PPHN was found in 17 patients in total. Eight patients received HFO and iNO, with a mortality rate of 40% (4/10). All four patients who received HFO alone died. One patient survived without HFO or iNO therapy. All seven patients without PPHN survived. Conclusions: The early mortality (＜3 days) rate (9/10, 90%) in our series was high. We also observed that the survival rate in the PPHN group increased after the introduction of inhaled NO therapy.