Objective: To review the evolution of golden hour management and outcomes for infants with congenital diaphragmatic hernia (CDH).
Study Design: Retrospective single center cohort study of infants with CDH born 2008-2023 at a quaternary children's hospital. Infants were grouped into 3 epochs: 2008-2013, 2014-2018, and 2019-2023. Outcome measures included extracorporeal membrane oxygenation therapy and survival.
Result: There were 454 infants, including 106 (2008-2013), 156 (2014-2018), and 192 (2019-2023). Despite increased disease severity, survival improved over time, from 71% (2008-2013) to 82% (2014-2018) and 83% (2019-2023), p = 0.02 for trend, with no difference in ECMO utilization.
Conclusion: Management of infants with CDH continues to evolve with ongoing experience at our high-volume center. Despite increasing severity of illness, survival outcomes have improved over time. In the absence of clinical trial data, observational data should be evaluated rigorously to inform care in a data-driven manner.
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