Association between Time with Open Ductus Arteriosus and Outcomes in Congenital Diaphragmatic Hernia.

Neonatology Pub Date : 2024-11-06 DOI:10.1159/000541385

Srirupa Hari Gopal, Robert Tillman, James D Hammond Ii, Joseph L Hagan, Sharada H Gowda, Nidhy P Varghese, Caraciolo J Fernandes

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Abstract

Introduction: While a patent ductus arteriosus (PDA) helps offload the right ventricle in the acute congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension, its role on long-term outcomes in CDH has not been investigated. Our objective was to examine associations of the PDA with long-term clinical outcomes in CDH.

Methods: A single-center retrospective descriptive study of 122 CDH patients dichotomized by duration with PDA, as ≤14 versus >14 postnatal days (PND) and ≤30 versus >30 PND. Fisher's exact test, Wilcoxon rank-sum test, and multiple linear and logistic regression analyses were used for analyses.

Results: In unadjusted and adjusted for CDH severity comparisons, patients with PDA >14 PND and >30 PND had a higher risk of death, longer length of stay, mechanical ventilation duration, and need for tracheostomy, diuretics, and PH medications at discharge.

Conclusion: A PDA beyond the newborn period is associated with adverse outcomes in infants with CDH.

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先天性膈疝患者开放动脉导管的时间与预后之间的关系

导言：虽然动脉导管未闭（PDA）有助于在急性先天性膈疝（CDH）相关性肺动脉高压时减轻右心室的负荷，但其对 CDH 长期预后的作用尚未得到研究。我们的目的是研究 PDA 与 CDH 长期临床预后的关系：单中心回顾性描述性研究：122 例 CDH 患者按 PDA 持续时间分为≤14 和 >14 个出生后日 (PND)，≤30 和 >30 个出生后日 (PND)。分析采用了费雪精确检验、Wilcoxon秩和检验、多元线性回归分析和逻辑回归分析：结果：在未调整CDH严重程度和调整CDH严重程度的比较中，PDA>14 PND和>30 PND的患者死亡风险更高，住院时间更长，机械通气时间更长，出院时需要气管造口术、利尿剂和PH药物：结论：超过新生儿期的 PDA 与 CDH 婴儿的不良预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neonatology

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