Early, Postnatal Pulmonary Hypertension Severity Predicts In
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Pulmonary hypertension (PH) is the major pathophysiologic consequence of congenital diaphragmatic hernia (CDH). Researchers aimed to evaluate the association between early CDH-associated PH (CDH-PH) and inpatient outcomes.

The CDH Study Group registry was queried for infants born with echocardiograms before 48h of life. PH was categorized using echocardiographic findings: none, mild (right ventricular systolic pressure less than 2/3 systemic), moderate (between 2/3 systemic and systemic), or severe (supra-systemic). Univariate and multivariate analysis were performed. Adjusted Poisson regression was used to assess the primary composite outcome of mortality or oxygen support at 30 days.

Results:
--Of 1,472 patients, 86.5% had CDH-PH: 13.9% mild, 44.4% moderate, and 33.2% severe.

--On adjusted analysis, the primary outcome of mortality or oxygen support at 30 days occurred more frequently in infants with moderate (incidence rate ratio [IRR] 1.8) and severe CDH-PH (IRR 2.0).

--Extracorporeal life support (ECLS) utilization was associated only with severe CDH-PH after adjustment (IRR 1.8).

To summarize, early postnatal CDH-PH is associated with an increased risk of mortality or oxygen support at 30 days, as well as the use of ECLS. In neonates with CDH, an early echocardiogram is an important prognostic tool for early inpatient outcomes.

Source: https://www.karger.com/Article/Abstract/512966
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