Incidence and outcomes of patients with congenital diaphragmatic hernia and pulmonary sequestration
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Feb 2021 · 1 min read
In brief
In brief
Large registry study of 2,118 CDH patients identifies 3.4% incidence of concurrent bronchopulmonary sequestration, which independently doubles the risk of ECMO requirement and mortality even after controlling for defect size and other anomalies. CDH+BPS patients present with significantly larger diaphragmatic defects and worse outcomes than isolated CDH.
Written by the GCMD Library team from the article.
Abstract
Background
Bronchopulmonary sequestration (BPS) has long been identified in patients with congenital diaphragmatic hernia (CDH), however the reported incidence in the literature varies widely and is not based on large series.
Methods
Version 4 of the Congenital Diaphragmatic Hernia Study Group (CDHSG) included questions specifically identifying BPS-associated cases. The data were prospectively collected between 2015 and 2020. Clinical characteristics and outcomes for CDH+BPS patients were compared to patients without BPS using univariate and multiple regression analyses.
Results
Out of 2118 total patients, 72 had a pulmonary sequestration (3.4%). The amount of CDH+BPS with high-risk (CDHSG type C and D) defects was significantly greater than those without BPS (68.0% vs 49.3%, respectively; p = 0.001). The need for ECLS (35/72, 48.6%) and overall mortality (21/72, 29.2%) was significantly higher in CDH+BPS. When corrected for hernia size, cardiac and chromosomal anomalies, the need for ECLS (OR 2.2, p = 0.004) and mortality (OR 2.0, p = 0.015) was significantly greater in CDH+BPS.
Conclusions
This is the largest series to look at the incidence of BPS in children with CDH. They are associated with larger defect sizes, a greater need for ECLS and higher mortality than those patients without BPS.