Abstract
Blood gas analysis can be used to reliably predict outcome in infants with congenital diaphragmatic hernia (CDH) both before and after surgical repair, providing these values are indexed to some measurement of alveolar ventilation. Until recently there has been difficulty in interpreting some of the published data because of differing sampling sites and the fact that ventilatory parameters, which have major influences on all blood gas values in this anomaly, were not included. Application of this information enables us to identify infants with similar degrees of severity of CDH in order to evaluate the efficacy of novel forms of therapy and to determine whether they represent a genuine advance in management where more conventional forms of treatment have failed.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bartlett RH, Andrews AF, Toomasian JM, Haiduc NJ, Gazzaniga AB (1982) Extracorporeal membrane oxygenation (ECMO) for newborn respiratory failure — 45 cases. Surgery 92: 425–433
Berdon WE, Baker DH, Amoury R (1968) the role of pulmonary hypoplasia in the prognosis of newborn infants with diaphragmatic hernia and eventration. AJR 103: 413–421
Bloss RS, Turmen T, Beardmore HE, Aranda JV (1980) Tolazoline therapy for persistent pulmonary hypertension after diaphragmatic hernia repair. J Pediatr 97: 984–988
Bohn DJ, James I, Filler RM, Ein SH, Wesson DE, Shandling B, Stephens C, Barker GA (1984) The relationship between PaCO2 and ventilation parameters in predicting survival in congenital diaphragmatic hernia. J Pediatr Surg 19: 666–671
Bohn DJ, Tamura M, Perrin D, Barker GA, Rabinovitch M (1987) Ventilatory predictors of pulmonary hypoplasia in congenital diaphragmatic hernia, confirmed by morphometry. J Pediatr 111: 423–431
Boix-Ochoa J, Peguero G, Seijo G, Natal A, Canals J (1974) Acid-base balance and blood gases in prognosis and therapy of congenital diaphragmatic hernia. J Pediatr Surg 19: 49–57
Boles ET, Schiller M, Weinberger M (1971) Improved management of neonates with congenital diaphragmatic hernias. Arch Surg 103: 344–349
Boynton BR, Mannino FL, Davis RF, Kopotic RJ, Friederichsen G (1984) Combined high-frequency oscillatory ventilation and intermittent mandatory ventilation in critically ill neonates. J Pediatr 105: 297–302
Comroe J, Forster R, Dubois A (1984) The lung. Year Book Medical Publishers, Chicago, p 339
Dibbins AW, Wiener ES (1974) Mortality from diaphragmatic hernia. J Pediatr Surg 9: 653–662
Drummond WH, Gregory GA, Heymann MA, Phibbs RA (1981) The independent effects of hyperventilation, tolazoline, and dopamine on infants with persistent pulmonary hypertension. J Pediatr 98: 603–611
Ein SH, Barker GA, Olley P (1980) The pharmacological treatment of newborn diaphragmatic hernia — a 2-year evaluation. J Pediatr Surg 15: 384–394
Fitzgerald RJ (1977) Congenital diaphragmatic hernia: a study of mortality factors. Ir J Med Sci 146: 280–284
Harrington J, Raphaely RC, Downes JJ (1982) Relationship of alveolar-arterial oxygen tension difference in diaphragmatic hernia of the newborn. Anesthesiology 56: 473–476
Karl SR, Thomas VN, Snider MT (1983) High frequency ventilation at rates of 375 to 1800 cycles per minute in four neonates with congenital diaphragmatic hernia. J Pediatr Surg 18: 822–828
Krummel TM, Greenfield LJ, Kirkpatrick BV, Mueller DG, Kerkering KW, Ormazabal M, Napolitano A, Salzberg AM (1984) J Pediatr Surg 19: 380–384
Mishalany HG, Nakkada K, Woolley MM (1979) Congenital diaphragmatic hernias; eleven years experience. Arch Surg 114: 1118–1123
Raphaely RC, Downes JJ (1973) Congenital diaphragmatic hernia: prediction of survival. J Pediatr Surg 8: 815–823
Ruff SJ, Campbell JR, Harrison MW, Campbell TJ (1980) Pediatric diaphragmatic hernias. Am J Surg 139: 641–645
Sakai H, Tamura M, Bohn DJ, Bryan AC, Barker GA (1987) The effect of surgical repair on respiratory mechanics in congenital diaphragmatic hernia. J Pediatr 111: 432–438
Shochat SJ, Naeye RL, Ford WDA, Whitman V, Maisels MJ (1979) Congenital diaphragmatic hernia: new concept in management. Ann Surg 190: 332–341
Snyder WH, Greaney EM (1965) Congenital diaphragmatic hernia; 77 consecutive cases. Surgery 57: 576–588
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bohn, D. Blood gas and ventilatory parameters in predicting survival in congenital diaphragmatic hernia. Pediatr Surg Int 2, 336–340 (1987). https://doi.org/10.1007/BF00175645
Issue Date:
DOI: https://doi.org/10.1007/BF00175645