Impact of a standardized management guideline for infants with CDH: A single-center experience
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In brief
In brief
Single-center study demonstrates that implementing a standardized clinical practice guideline for infants with congenital diaphragmatic hernia significantly reduced ECMO utilization from 50% to 18% without compromising outcomes. The retrospective analysis compared 133 patients before and after guideline implementation over a 14-year period.
Written by the GCMD Library team from the article.
Background
: Infants with congenital diaphragmatic hernia (CDH) are at high risk of death, even despite extracorporeal membrane oxygenation (ECMO) support. In January 2012 we implemented a standardized clinical practice guideline (CPG) to manage infants with CDH. We hypothesized that infants with CDH managed with CPG had better clinical outcomes, less ECMO utilization, and increased survival to discharge.
Methods
: We conducted a retrospective pre-post study of infants with CDH admitted between January 2007 and July 2021 (n=133). Patients were divided into Cohort 1, pre-CPG (January 2007 to December 2011, n=54), and Cohort 2, post-CPG (January 2012 to July 2021, n=79).
Results
: More patients in Cohort 1 were small for gestational age than in Cohort 2. No other patient demographics were different between cohorts. Cohort 2 had significantly lower ECMO utilization as compared to Cohort 1 (18% vs 50%, p