AI Article Synopsis
- The study investigates the best timing for surgery in patients with congenital diaphragmatic hernia (CDH) by using a measurement called the left-to-right flow ratio of the patent ductus arteriosus (PDA).
- Researchers compared two groups: one that followed a specific protocol for surgery timing (2010-2020) and a historical control group that did not (2007-2009).
- Results showed that while survival rates and worsening pulmonary hypertension post-surgery were similar, the protocol group experienced significantly shorter durations of tracheal intubation, suggesting the protocol may allow for earlier and safer surgeries.
Article Abstract
Purpose: The optimal timing of surgery for congenital diaphragmatic hernia (CDH) is controversial. We aimed to validate our protocol for the timing of CDH repair using the quantified patent ductus arteriosus (PDA) flow pattern.
Methods: This retrospective comparative study analyzed patients with a prenatal diagnosis of isolated CDH between 2007 and 2020. We defined the "LR ratio" as the percentage of velocity-time integral (VTI) of the left-to-right flow of PDA against overall VTI on echocardiography. Since 2010, we followed the decision criterion of performing surgery when LR ratio of > 50% has been achieved in the patients (protocol group). The protocol group (2010-2020) was compared with the historical control group (2007-2009).
Results: The average age at surgery was 104.1 ± 175.9 and 37.3 ± 30.6 h in the control and protocol groups, respectively (p = 0.11). Survival rate (88.9% vs. 95.0%, p = 0.53) and the rate of worsening of pulmonary hypertension within 24 h after surgery (22.2% vs. 10.0%, p = 0.57) were not different between the groups. The protocol group had a significantly shorter duration of tracheal intubation (26.9 ± 21.1 vs. 13.3 ± 9.5 days, p = 0.03).
Conclusion: Our decision criterion might have the advantage of facilitating early and safe surgery for patients with CDH.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778689 | PMC |
| http://dx.doi.org/10.1007/s00383-020-04788-9 | DOI Listing |
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