The Pulmonary Hypertension in Newborn Suffer from Congenital Diaphragmatic Hernia at Viet Nam National Children Hospital

Abstract

Objectives: To evaluate the outcome and risk factors related to persistent pulmonary hypertension in newborn of congenital diaphragmatic hernia. Subjects and methods: Descriptive study, patients with congenital diaphragmatic hernia (HDH) treated at the Vietnam National Children’s Hospital, the period of this study was from 01/01/2012 to 30/06/2015, assessed pulmonary hypertension (PAH) by Doppler ultrasonography, divided the level of PAH from light to severe PAH. The risk factors taken on admission and during treatment. Data were analyzed on SPSS 20.0, multivariate regression analysis to find factors related to pulmonary hypertension. Results: Mean pulmonary arterial pressure during 24-hour of admission was 46 ± 20 mmHg (10-88 mmHg). The rate of PAH in CDH was 72,6%, with of 58.9% patients were moderate to severe PAH. Moderate to severe PAH was a significant risk factor for mortality in CHD with OR: 20.05; 95%CI: 7.2-70.3. Multivariate regression analysis of factors related to moderate to severe PAH was statistically significant: hospitalization age less than 24 hours < 24 hours (OR: 3.93; 95% CI: 1.23-12.53); endotracheal intubation postpartum (OR: 3.09; 95% CI: 1.26-7.56); and administration of more than 2 vasopressures/inotrops before surgery (OR: 11.09; 95% CI: 2.44-50.37). Conclusion: The rate of PAH in patient’s CDH is 72,6%. Moderate and severe PAH is a risk factor for mortality of CDH. Factors related to moderate to severe PAH in CDH were hospitalization age less than 24 hours, endotracheal intubation postpartum and administration of more than 2 vasopressures/inotrops before surgery.