Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten cases of posterolateral diaphragmatic hernia have been operated upon the last two years. Three cases of these have successfully been operated in conventional way. In seven cases ductus arteriosus was closed. Only two cases survived. A preoperative evaluation is to be done. Depending on the blood-gas-analysis, the cases can be divided into cases belonging to the survival zone and cases belonging to the fatal zone according to Boix-Ochoa. If it is possible to increase the oxygen uptake and to expire the carbonic acid, the results seem to be good after conventional operation. If it not will be possible to increase the oxygen saturation and not even possible to reduce the CO2 pressure with a ventilator with 100 per cent oxygen, the cases are to be considered inoperable. In fatal zone cases, where a reduction of PCO2 is possible, but there are no possibilities to get an increased oxygen saturation, an operative closing of ductus can be tried if heart anoxia is treated with the aid of an oxygenator.
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PMID:[Experiences about ductus arteriosus closure with congenital diaphragmatic hernia (author's transl)]. 53 Jul 19

Thirty-two infants were treated for congenital diaphragmatic hernia at our institution from 1979 to 1984. Eight were in no or minimal distress at birth and had operative intervention when they were more than 24 hours old; survival was 100%. The remaining 24 neonates required immediate intubation and ventilation followed by operation at less than 12 hours of age. Overall survival was 54%; survival was 31% (4 of 13 patients, Group 1) in the first three years of the series and 82% (9 of 11 patients, Group 2) in the last three years (p less than 0.001). Apgar score, gestational age, birth weight, and incidence of associated congenital heart disease were equal for the two groups (all, p greater than 0.05). The two groups also were examined with reference to alveolar-arterial oxygen differences P(A-a)O2 and mean airway pressure (MAP). The best preoperative P(A-a)O2 was greater than 600 mm Hg for 7 neonates in Group 1 and 6 in Group 2, and survival was 0% and 71%, respectively (p less than 0.001). Infants with a postoperative MAP of 13 cm H2O or greater had a higher mortality (100% in Group 1 and 50% in Group 2, p greater than 0.05). Our treatment protocol was studied to determine those methods related to improved survival. Sodium bicarbonate infusion was used earlier in Group 2 as a prophylaxis against persistent fetal circulation (PFC) (p greater than 0.05). The incidence of severe PFC dropped from 85 to 54% (p greater than 0.05). Higher ventilator rates rather than pressures were used to achieve equally effective ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Improving survival in the treatment of congenital diaphragmatic hernia. 394 36