Association between initial ventilation mode and hospital outcomes for severe congenital diaphragmatic hernia

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 de...

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Bibliographic Details
Published in:Journal of perinatology 2024-09, Vol.44 (9), p.1353-1358
Main Authors: Wild, K. Taylor, Mathew, Leny, Ades, Anne M., Rintoul, Natalie E., Soorikian, Leane, Matthews, Kelle, Lee, Sura, Van Hoose, K. Taylor, Kesler, Erin, Flohr, Sabrina, Bostwick, Anna, Reynolds, Tom, Hedrick, Holly L., Foglia, Elizabeth E.
Format: Article
Language:English
Subjects:
692/308/409
692/700/1720
Blood
Blood Gas Analysis
Carbon dioxide
Carbon Dioxide - blood
Design of experiments
Diaphragm
Experimental design
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - methods
Female
Gas exchange
Gases
Hernia
Hernias
Hernias, Diaphragmatic, Congenital - mortality
Hernias, Diaphragmatic, Congenital - therapy
High-Frequency Ventilation - methods
Hospitalization
Hospitals
Humans
Infant, Newborn
Infants
Intubation
Length of Stay
Male
Mechanical ventilation
Medicine
Medicine & Public Health
Mortality
Pediatric Surgery
Pediatrics
Quasi-experimental methods
Regression analysis
Respiration, Artificial
Severity of Illness Index
Survival
Treatment Outcome
Ventilation
Ventilators
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Summary: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 
ISSN:0743-8346
1476-5543
1476-5543
DOI:10.1038/s41372-024-02024-z