Early outcome of congenital diaphragmatic hernia in a Malaysian tertiary centre

Rohana Jaafar, N. Y. Boo, C. R. Thambidorai

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: This prospective observational study was conducted to determine the outcome of newborns with congenital diaphragmatic hernia (CDH). They were managed with a protocol of gentle ventilation to avoid barotraumas, and inhaled nitric oxide (iNO) or intravenous magnesium sulphate for treatment of persistent pulmonary hypertension of newborns (PPHN). Methods: All newborns with CDH admitted to neonatal intensive care unit of this hospital during the six-year study period were recruited. High frequency oscillatory ventilation was used when infants required peak inspiratory pressure of more than 25 mmHg.iNO at 20 ppm or intravenous magnesium sulphate was used when PPHN developed. Arterial blood pH was maintained between 7.35 and 7.45, and partial pressure of arterial carbon dioxide was kept above 35 mmHg. Surgery was performed when the infants' general condition and blood gases were stabilised for at least 24 hours. Results: Of 21 infants recruited (15 males and six females, median gestational age 39.0 weeks, median birth weight 2,800 grams), 52.4 percent had PPHN. 12 (57.1 percent) underwent surgery at a median age of 4.9 days. One died postoperatively due to PPHN. Out of the 21 subjects, 11 (52.4 percent) survived to discharge. There was no significant difference in the demographic characteristics, side and size of CDH defects, presence of PPHN, or type of treatment received, between infants who survived and died. However, infants who died had significantly lower mean Apgar scores at five minutes of life (p-value is 0.02), and higher mean oxygenation indexes (OI) (p-value is 0.01) than those of survivors. Two (18.2 percent) of the II survivors developed chronic lung disease. Conclusion: Low Apgar scores and high OI were associated with poor outcome in infants with CDH.

Original languageEnglish
Pages (from-to)142-144
Number of pages3
JournalSingapore Medical Journal
Volume49
Issue number2
Publication statusPublished - Feb 2008

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Persistent Fetal Circulation Syndrome
Magnesium Sulfate
Apgar Score
Survivors
Nitric Oxide
Newborn Infant
Barotrauma
High-Frequency Ventilation
Value of Life
Partial Pressure
Neonatal Intensive Care Units
Birth Weight
Carbon Dioxide
Lung Diseases
Gestational Age
Observational Studies
Ventilation
Congenital Diaphragmatic Hernias
Chronic Disease
Gases

Keywords

  • Congenital diaphragmatic hernia
  • Inhaled nitric oxide
  • Magnesium sulphate
  • Persistent pulmonary hypertension of newborns

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Early outcome of congenital diaphragmatic hernia in a Malaysian tertiary centre. / Jaafar, Rohana; Boo, N. Y.; Thambidorai, C. R.

In: Singapore Medical Journal, Vol. 49, No. 2, 02.2008, p. 142-144.

Research output: Contribution to journalArticle

Jaafar, Rohana ; Boo, N. Y. ; Thambidorai, C. R. / Early outcome of congenital diaphragmatic hernia in a Malaysian tertiary centre. In: Singapore Medical Journal. 2008 ; Vol. 49, No. 2. pp. 142-144.
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