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Objective <p>To review the evolution of golden hour management and outcomes for infants with congenital diaphragmatic hernia (CDH).</p> Study design <p>Retrospective single center cohort study of infants with CDH born 2008–2023 at a quaternary children’s hospital. Infants were grouped into 3 epochs: 2008–2013, 2014–2018, and 2019–2023. Outcome measures included extracorporeal membrane oxygenation therapy and survival.</p> Result <p>There were 454 infants, including 106 (2008–2013), 156 (2014–2018), and 192 (2019–2023). Despite increased disease severity, survival improved over time, from 71% (2008–2013) to 82% (2014–2018) and 83% (2019–2023), <i>p</i> = 0.02 for trend, with no difference in ECMO utilization.</p> Conclusion <p>Management of infants with CDH continues to evolve with ongoing experience at our high-volume center. Despite increasing severity of illness, survival outcomes have improved over time. In the absence of clinical trial data, observational data should be evaluated rigorously to inform care in a data-driven manner.</p>

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Golden hour management of infants with congenital diaphragmatic hernia: 15 year experience at a high-volume center

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月21日

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  • K. Taylor Wild,
  • Holly L. Hedrick,
  • Natalie E. Rintoul,
  • Anne M. Ades,
  • Juliana S. Gebb,
  • Leny Mathew,
  • Tom Reynolds,
  • Anna Bostwick,
  • Elizabeth Eppley,
  • Sabrina Flohr,
  • N. Scott Adzick,
  • Elizabeth E. Foglia

摘要

Objective

To review the evolution of golden hour management and outcomes for infants with congenital diaphragmatic hernia (CDH).

Study design

Retrospective single center cohort study of infants with CDH born 2008–2023 at a quaternary children’s hospital. Infants were grouped into 3 epochs: 2008–2013, 2014–2018, and 2019–2023. Outcome measures included extracorporeal membrane oxygenation therapy and survival.

Result

There were 454 infants, including 106 (2008–2013), 156 (2014–2018), and 192 (2019–2023). Despite increased disease severity, survival improved over time, from 71% (2008–2013) to 82% (2014–2018) and 83% (2019–2023), p = 0.02 for trend, with no difference in ECMO utilization.

Conclusion

Management of infants with CDH continues to evolve with ongoing experience at our high-volume center. Despite increasing severity of illness, survival outcomes have improved over time. In the absence of clinical trial data, observational data should be evaluated rigorously to inform care in a data-driven manner.