CONGENITAL DIAPHRAGMATIC-HERNIA - IMMEDIATE PREOPERATIVE AND POSTOPERATIVE OXYGEN GRADIENTS IDENTIFY PATIENTS REQUIRING PROLONGED RESPIRATORY SUPPORT
- 1 January 1983
- journal article
- research article
- Vol. 93 (1) , 83-87
Abstract
A total of 22 newborn with congenital diaphragmatic hernias were reviewed. In all operative repair was undertaken within 24 h of birth, in the period between 1970 and 1981. An improvement in survival rates since 1977 was observed. Preoperative pH, PO2 [partial pressure] and alveolar-arterial O2 gradients (P[A-a]O2) had predictive value. Patients with P(A-a)O2 > 500 torr both before and immediately after surgery did not survive. After an initial improvement in oxygenation, some infants experienced a period of deterioration beginning at approximately 12-24 h, peaking at 36 h and improvement by 72 h after surgery. Special attention should be directed toward maintaining aggressive cardiopulmonary support during this critical period. Reducing support prematurely may accentuate right-to-left shunting via fetal channels.This publication has 3 references indexed in Scilit:
- Control of release of surfactant phospholipids in the isolated perfused rat lungJournal of Applied Physiology, 1981
- Tolazoline therapy for persistent pulmonary hypertension after congenital diaphragmatic hernia repairThe Journal of Pediatrics, 1980
- Unsuspected Pulmonary Vascular Abnormalities Associated With Diaphragmatic HerniaPediatrics, 1976