Abstract : INTRODUCTION Neonatal intensive care unit (NICU) stabilization strategies which normalize physiolog
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Abstract : INTRODUCTION Neonatal intensive care unit (NICU) stabilization strategies which normalize physiology according to predetermined blood gas targets may contribute to observed improved survival rates of patients with CDH. The purpose of our study was to compare risk-adjusted outcomes of CDH patients managed with or without blood gas targets established at NICU admission.|METHODS Cases were collected from a national CDH network between May 2005 and November 2007. On NICU admission the responsible neonatologist was asked to establish target ranges for pH pCO (2) pO (2) and pre/post-ductal O (2) saturation. The outcomes analyzed were mortality need for ECMO days of mechanical ventilation/supplemental oxygen and length of stay.|RESULTS Of 147 CDH infants 63 had admission blood gas targets. Severity of illness and gestational age in both groups were comparable (SNAP-II score). Infants with blood gas targets had a significantly lower mortality than those without (Hazard ratio 0.27 p=0.006).|CONCLUSIONS: Blood gas targets for the management of infants with CDH are associated with improved survival. Although the willingness to create and use stabilization targets to guide early NICU care may be a surrogate for other factors (experience, staffing, lack of interest), it is clearly associated with improved survival in CDH.|
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