Effect of hospital volume on the mortality of congenital diaphragmatic hernia in <scp>J</scp>apan

Hayakawa, Masahiro; Ito, Motokazu; Hattori, Tetsuo; Kanamori, Yutaka; Okuyama, Hiroomi; Inamura, Noboru; Takahashi, Satoshi; Nagata, Kouji; Taguchi, Tomoaki; Usui, Noriaki

doi:10.1111/ped.12059

Cited by 22 publications

(14 citation statements)

References 27 publications

(64 reference statements)

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“…CDH patients treated in 5 years <10), it was available in only 46.8% of the institutions. 12 In other words, high-volume hospitals tend to attract move severe cases of CDH requiring ECMO. The criteria for initiating ECMO, however, are different in high-volume hospitals.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan

Inamura

Usui

Okuyama

et al. 2015

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan

Inamura

Usui

Okuyama

et al. 2015

Pediatrics International

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“…At birth, these changes lead to respiratory insufficiency and persistent pulmonary hypertension (PPHT) 3. The latter is lethal in up to 30%, despite prenatal referral to high volume centres that offer standardised neonatal care 4 5. Survivors may suffer from additional morbidities such as chronic PPHT in up to 50% of cases, chronic lung disease, gastro-oesophageal reflux and, later in life, thoracic deformations 6…”

Section: Introductionmentioning

confidence: 99%

Transplacental sildenafil rescues lung abnormalities in the rabbit model of diaphragmatic hernia

Russo

Toelen

Eastwood

et al. 2016

Thorax

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“…Estimation of severity is used for counselling parents on prenatal options, such as in utero referral, termination of pregnancy, or fetal therapy, which at present is investigational. In ongoing pregnancies prenatal diagnosis and planned delivery at high‐volume centres seem to increase survival . Most prediction studies involve fetuses with isolated left‐sided CDH (LCDH).…”

Section: Introductionmentioning

confidence: 99%

Right‐sided congenital diaphragmatic hernia in a decade of fetal surgery

DeKoninck

Gómez

Sandaite

et al. 2014

BJOG

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Objective To report a recent update on fetuses with right-sided congenital diaphragmatic hernia (RCDH) in the era of fetal surgery.Design Retrospective review of prospectively collected data.Setting Fetal treatment centres in Leuven and Barcelona.Population Consecutive cases of RCDH between 2002 and 2012.Methods Data on prenatal imaging, genetic testing, pregnancy and neonatal outcomes were extracted from our databases, including structural and genetic anomalies, candidate outcome predictors such as lung size, liver herniation ratio, polyhydramnios, cervical length, preterm prelabour rupture of membranes and gestational age at birth.Main outcome measures Survival and oxygen dependency at discharge.Results Ten out of 86 fetuses with RCDH had associated abnormalities. Of 76 isolated pregnancies, eight women opted for termination of pregnancy, most with severe hypoplasia and one was lost to follow up. Nineteen pregnancies were expectantly managed and delivered at a mean gestational age of 36.0 AE 3.0 weeks. Survival at discharge was 53% (10/19), one being oxygen dependent. In the fetal surgery group (n = 48), mean gestational age at delivery was 34.5 AE 3.0 weeks. In our recent experience not previously published (n = 23) survival rate was 52 and 39% were oxygen dependent at discharge. Pooling these data with earlier reported observations by our group we observed a 42% survival rate in 57 fetuses. Lung size on magnetic resonance imaging and an interval of >24 hours between reversal of tracheal occlusion and delivery were predictors of outcome.Conclusions Right-sided CDH seems to have a poorer outcome than that reported for fetuses with left-sided CDH with similar lung size before birth. Survival rates after expectant management with observed/expected lung-to-head ratio values ≤45 and ≤30% were 17 and 0%, respectively. In those undergoing fetal surgery (observed/expected lung-to-head ratio ≤45%) there was an apparent increase (42%).Keywords Congenital diaphragmatic hernia, fetal therapy, magnetic resonance imaging, tracheal occlusion, ultrasound.Linked article This article is commented on by J Balayla, p. 947 in this issue. To view this mini commentary visit http:// dx.doi.org/10.1111/1471-0528.13077.Please cite this paper as: DeKoninck P, Gomez O, Sandaite I, Richter J, Nawapun K, Eerdekens A, Ramirez JC, Claus F, Gratacos E, Deprest J. Right-sided congenital diaphragmatic hernia in a decade of fetal surgery. BJOG 2015;122:940-946.

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Effect of hospital volume on the mortality of congenital diaphragmatic hernia in Japan

Abstract: We concluded that it might therefore be important to centralize infants with CDH, especially those with isolated CDH with a prenatal diagnosis, to tertiary centers in Japan in order to improve the survival rates.

Cited by 22 publications

References 27 publications

Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan

Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan

Transplacental sildenafil rescues lung abnormalities in the rabbit model of diaphragmatic hernia

Right‐sided congenital diaphragmatic hernia in a decade of fetal surgery

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