Original Research Article
Year: 2019 | Month: September | Volume: 6 | Issue: 9 | Pages: 103-107
Prediction of Neonatal Morbidity in Survivors with CDH In Relation to Post-Operative Intravesical Pressure and LHR
Narasimha KN1, Divya Prakash2, Neharika3
1Senior Resident, Indira Gandhi Institute of Child Health, Bangalore
2Senior Resident, Department of Pediatric Surgery, Ram Manohar Lohia Hospital, Lucknow
3Assistant Professor, Dept. of Surgery, Hind Institute of Medical Sciences, Barabanki, UP - 225003
Corresponding Author: Divya Prakash
ABSTRACT
Aim: was to evaluate an indicator that predicts the postoperative course, once other indices have predicted survival and fitness for surgery
Material and method: Thirty consecutive cases that underwent repair of congenital diaphragmatic hernia from April 2012 to July 2015 were studied prospectively. The preoperative and postoperative intravesical pressures were measured in all patients in the operating room. The patients were catheterized with a 6F infant feeding tube. The abdomen was opened through an upper abdominal transverse incision. The diaphragmatic defect was identified, contents were reduced and the defect closed. The abdominal wall was stretched to increase the volume of the abdominal cavity. The peritoneum was closed. The bladder pressure was measured as recommended by the World Society for Abdominal Compartment Syndrome (WSACS). Morbidity was evaluated in terms of the number of days of post operative ventilation.
Results: Using LHR and postoperative ventilation days as continuous variables, the Pearson’s correlation coefficient was found to be -0.574 (r) which was significant. There exist a moderately positive and moderately high relationship between the number of days of post-operative ventilation and bladder pressure.
Conclusion: Postoperative intravesical pressure and lung to head circumference ratio (LHR) are valuable factors in the prediction of neonatal morbidity in survivors with congenital diaphragmatic hernia (CDH).
Key words: Hernia, CDH, LHR
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