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International Journal of Pediatrics
Volume 2012, Article ID 402170, 7 pages
http://dx.doi.org/10.1155/2012/402170
Clinical Study

Is the Time Necessary to Obtain Preoperative Stabilization a Predictive Index of Outcome in Neonatal Congenital Diaphragmatic Hernia?

1Department of Paediatric Anaesthesia and Intensive Care, S. Orsola-Malpighi Hospital, University of Bologna, 40183 Bologna, Italy
2Department of Cardiology, S. Orsola-Malpighi Hospital, University of Bologna, 40183 Bologna, Italy
3Department of Surgical Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, 40183 Bologna, Italy

Received 3 July 2011; Accepted 3 November 2011

Academic Editor: Tsu F. Yeh

Copyright © 2012 Andrea Gentili et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The study aims to verify if the time of preoperative stabilization (≤24 or >24 hours) could be predictive for the severity of clinical condition among patients affected by congenital diaphragmatic hernia. Methods. 55 of the 73 patients enrolled in the study achieved presurgical stabilization and underwent surgical correction. Respiratory and hemodynamic indexes, postnatal scores, the need for advanced respiratory support, the length of HFOV, tracheal intubation, PICU, and hospital stay were compared between patients reaching stabilization in ≤24 or >24 hours. Results. Both groups had a 100% survival rate. Neonates stabilized in ≤24 hours are more regular in the postoperative period and had an easier intensive care path; those taking >24 hours showed more complications and their care path was longer and more complex. Conclusions. The length of preoperative stabilization does not affect mortality, but is a valid parameter to identify difficulties in survivors’ clinical pathway.