Congenital diaphragmatic hernia in newborns
Hernia diafragmática congénita en recién nacidos
Author
Quinteros Sch., Alvaro
Bancalari M., Aldo
Abstract
With the aim of becoming acquainted with some characteristics of newborns as bearers of congenital diaphragmatic hernia (HDC), to determine lethality on the basis of surgical intervention (SI) timing, and predict the survival of this patients according the relation between the PaCO2 and the IVM at the moment of the surgery, 38 neonates hospitalized in the Neonatology Unit of Guillermo Grant Benavente Hospital have been retrospectively studied. Surgery was perfomed en thirty neonates. Thirteen of them were operated before 24 hours of birth, death occuring in 61,5% of them. The remaining seventeen were operated as soon as their hemodynamics and breathing had been stabilized. Death occurring in 41,2%. Upon surgery, seventeen neonates were placed in square B of Bohn s diagram obtaining a 70,5% survival rate; four neonates in square A with 50% survival and six in square C with 100% mortality. The mortality in our series was 60,5%. These data suggests that the survival rate could be greater in neonates whose hemodynamics and breathing had been previously stabilized. The optimun timing for surgical intervention should be as soon as they had been placed in Bohn s square B. Con el objeto de conocer algunas características clínicas de los recién nacidos (RN) portadores de hernia diafragmática congénita (HDC), determinar letalidad según momento de intervención quirúrgica (IQ) y predecir la sobrevida de estos pacientes según la relación entre la PaCO2 y el índice ventilatorio modificado al momento de la IQ, se estudiaron retrospectivamente 38 RN hospitalizados en la Unidad de Neonatología del Hospital Guillermo Grant Benavente. En 30 RN se logró realizar IQ, de ellos 13 se operaron antes de las 24 horas de vida falleciendo el 61,5%. Los 17 restantes se operaron después de la estabilización respiratoria y hemodinámica, falleciendo el 41,2%. 17 RN se ubicaron al momento de la IQ en el casillero B de Bohn obteniéndose una sobrevida de 70,5%, 4 en el casillero A sobreviviendo el 50% y 6 en el C falleciendo el 100%. La letalidad global de nuestra serie fue de 60,5%. Los resultados sugieren que la sobrevida es mayor en los RN operados previa estabilización respiratoria y hemodinámica, aunque no alcanzan una significación estadística concluyente.