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Objective <p>Identify how a core congenital diaphragmatic hernia (CDH) team coupled with early recognition and treatment of cardiac dysfunction changed outcomes for infants with CDH.</p> Methods <p>A retrospective chart review compared a historical cohort from 2015-2019 (<i>n</i> = 51) with a post-guideline cohort from 2020–2025 (<i>n</i> = 53). Statistical analysis was performed with Fisher’s exact, unpaired <i>t</i>-test, and Mann Whitney <i>U</i>-test.</p> Results <p>Survival improved from 68.6% to 88.7% (<i>p</i> = 0.016) and ECMO utilization decreased, 51.0% to 26.4% (<i>p</i> = 0.015). Infants with cardiac dysfunction had increased survival (47.3% vs. 81.8%, <i>p</i> = 0.014) and less ECMO utilization (68.4% vs. 36.3%, <i>p</i> = 0.043). Vasoactive choices evolved with dopamine replaced by norepinephrine, low-dose epinephrine, or calcium gluconate. Inhaled nitric oxide (iNO) use in the first 48 h decreased significantly while prostaglandin E1 (PGE1) use increased.</p> Discussion <p>We implemented a core CDH team focused on a generalizable, physiology-driven approach to identify and treat cardiac dysfunction using standard neonatal echocardiography to improve outcomes.</p>

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Team-based care with early recognition and treatment of cardiac dysfunction for infants with CDH

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月28日

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  • Patrick E. Sloan,
  • Lila S. Sanning,
  • Caren Liviskie,
  • Kristen Clark,
  • Kylie Bushroe,
  • Melissa Riley,
  • Anna Lijowska,
  • Jesse Vrecenak,
  • Tasnim Najaf

摘要

Objective

Identify how a core congenital diaphragmatic hernia (CDH) team coupled with early recognition and treatment of cardiac dysfunction changed outcomes for infants with CDH.

Methods

A retrospective chart review compared a historical cohort from 2015-2019 (n = 51) with a post-guideline cohort from 2020–2025 (n = 53). Statistical analysis was performed with Fisher’s exact, unpaired t-test, and Mann Whitney U-test.

Results

Survival improved from 68.6% to 88.7% (p = 0.016) and ECMO utilization decreased, 51.0% to 26.4% (p = 0.015). Infants with cardiac dysfunction had increased survival (47.3% vs. 81.8%, p = 0.014) and less ECMO utilization (68.4% vs. 36.3%, p = 0.043). Vasoactive choices evolved with dopamine replaced by norepinephrine, low-dose epinephrine, or calcium gluconate. Inhaled nitric oxide (iNO) use in the first 48 h decreased significantly while prostaglandin E1 (PGE1) use increased.

Discussion

We implemented a core CDH team focused on a generalizable, physiology-driven approach to identify and treat cardiac dysfunction using standard neonatal echocardiography to improve outcomes.