ArticleAnnals of surgery2006
Treatment evolution in high-risk congenital diaphragmatic hernia: ten years' experience with diaphragmatic agenesis.
Article in Annals of surgery, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 69 citations in OpenAlex.
- Risk factors for and developmental relation of delayed oral nutrition in infants with congenital diaphragmatic hernia.Pediatric surgery international · 2023Article
- Outcomes of neonatal congenital diaphragmatic hernia in a non-ECMO center in a middle-income country: a retrospective cohort study.BMC pediatrics · 2022Article
- Intra-amniotic Sildenafil Treatment Modulates Vascular Smooth Muscle Cell Phenotype in the Nitrofen Model of Congenital Diaphragmatic Hernia.Scientific reports · 2018Article
- Treatment Strategies for Congenital Diaphragmatic Hernia: Change Sometimes Comes Bearing Gifts.Frontiers in pediatrics · 2017Article
- Self-assessed physical health among children with congenital diaphragmatic hernia.Pediatric surgery international · 2016Article
- Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England.Annals of the Royal College of Surgeons of England · 2016Article
- The Surgical Correction of Congenital Deformities: The Treatment of Diaphragmatic Hernia, Esophageal Atresia and Small Bowel Atresia.Deutsches Arzteblatt international · 2015Review
- Initial oxygenation response to inhaled nitric oxide predicts improved outcome in congenital diaphragmatic hernia.Drugs in R&D · 2014Article
- Pulmonary support on day 30 as a predictor of morbidity and mortality in congenital diaphragmatic hernia.Journal of pediatric surgery · 2013Article
- Defective pulmonary innervation and autonomic imbalance in congenital diaphragmatic hernia.American journal of physiology. Lung cellular and molecular physiology · 2012Article
- Pulmonary artery size has prognostic value in low birth weight infants with congenital diaphragmatic hernia.Pediatric surgery international · 2011Article
- Single payer health insurance in pediatric surgery: US impressions and Canadian experience.Pediatric surgery international · 2011Article
- Effect of insulin-like growth factors on lung development in a nitrofen-induced CDH rat model.Pediatric surgery international · 2011Article
- Congenital diaphragmatic hernia: outcome review of 2,173 surgical repairs in US infants.Pediatric surgery international · 2009Review
- Significance of pulmonary artery size and blood flow as a predictor of outcome in congenital diaphragmatic hernia.Pediatric surgery international · 2008Article
- Management of pulmonary hypertension in congenital diaphragmatic hernia: nitric oxide with prostaglandin-E1 versus nitric oxide alone.Pediatric surgery international · 2008Article
- Teratogen-induced, dietary and genetic models of congenital diaphragmatic hernia share a common mechanism of pathogenesis.The American journal of pathology · 2006Article
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 3 countries.
Funding
Abstract
objectiveThe objective of this study was to evaluate the impact of newer therapies on the highest risk patients with congenital diaphragmatic hernia (CDH), those with agenesis of the diaphragm. SUMMARY BACKGROUND DATA: CDH remains a significant cause of neonatal mortality. Many novel therapeutic interventions have been used in these infants. Those children with large defects or agenesis of the diaphragm have the highest mortality and morbidity.
methodsTwenty centers from 5 countries collected data prospectively on all liveborn infants with CDH over a 10-year period. The treatment and outcomes in these patients were examined. Patients were followed until death or hospital discharge.
resultsA total of 1,569 patients with CDH were seen between January 1995 and December 2004 in 20 centers. A total of 218 patients (14%) had diaphragmatic agenesis and underwent repair. The overall survival for all patients was 68%, while survival was 54% in patients with agenesis. When patients with diaphragmatic agenesis from the first 2 years were compared with similar patients from the last 2 years, there was significantly less use of ECMO (75% vs. 52%) and an increased use of inhaled nitric oxide (iNO) (30% vs. 80%). There was a trend toward improved survival in patients with agenesis from 47% in the first 2 years to 59% in the last 2 years. The survivors with diaphragmatic agenesis had prolonged hospital stays compared with patients without agenesis (median, 68 vs. 30 days). For the last 2 years of the study, 36% of the patients with agenesis were discharged on tube feedings and 22% on oxygen therapy.
conclusionsThere has been a change in the management of infants with CDH with less frequent use of ECMO and a greater use of iNO in high-risk patients with a potential improvement in survival. However, the mortality, hospital length of stay, and morbidity in agenesis patients remain significant.
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