Published Paper Details:

Background: Congenital diaphragmatic hernia (CDH) is associated with significant morbidity and mortality. Survival rates for CDH neonates have increased with early prenatal detection and improved postnatal management. Aims and Objectives: To assess the Clinical profile, Risk factors for mortality and Analyze the Predictors affecting the Outcome at discharge for neonates with CDH. Materials and Methods: This was a retrospective study conducted over a period of 03 years in a tertiary care in North Karnataka, India. Clinical characteristics and risk factors of 15 neonates diagnosed with CDH were compared between survivors and non-survivors. Neonates with clinical and intra operative diagnosis of diaphragmatic eventration were not included in this study. Results: A total of 15 neonates diagnosed with CDH were included. There was a significant difference between CDH neonates who survived (87%) and those who died (13%), in terms of onset of respiratory distress, preoperative ventilation, the presence of severe PPHN, maximum OI on day 1, surfactant administration, large defect size, intrathoracic liver, sepsis and length of hospital stay with (P < 0.05). The maximum OI on first day < 15 and absence of severe PPHN predicted the survival for CDH neonates. (P value<0.005). Conclusion: The overall survival rate among CDH neonates in our institutional experience was good. Risk factors for mortality include onset of respiratory distress, maximum OI > 15 on first day and need for preoperative ventilation. Maximum OI on first day < 15 and absence of severe pulmonary hypertension are good predictors of the survival for CDH neonates.