Survival of outborns with congenital diaphragmatic hernia: the role of protective ventilation, early presentation and transport distance: a retrospective cohort study

Table 3 Interventions and type of surgical repair in neonates with congenital diaphragmatic hernia

Characteristic	Epoch I	Epoch II	P-value
Characteristic	(N = 26)	(N = 57)	P-value
Primary mechanical ventilation, n (%)			<0.001
Intermittent mandatory ventilation	26 (100)	0 (0)
Assist-control + volume limit mode	0 (0)	26 (45)
Pressure support + volume guarantee mode	0 (0)	31 (55)
High frequency oscillatory ventilation^a	0 (0)	8 (15)	----
Inhaled nitric oxide	0 (0)	31 (54)	<0.001
Surfactant administration	1 (4)	16 (28)	<0.001
Vasoactive support	13 (50)	55 (96)	<0.001
Died before surgery	7 (27)	12 (21)	0.815
Time between delivery and surgery, hours^b	24.5 [24.7, 28.2]	29 [23.0, 29.0]	0.550
Type of surgical repair	19 (73)	45 (79)	0.815
Primary closure	18	39
Patch repair	1	5
Muscle flap repair	0	1

All values are N (%) or median [25^th, 75^th percentile]
^aUsed only as a rescue technique
^bAlthough current practice shifted from emergent repair of CDH to a policy of preoperative medical stabilization using a variety of intensive care management strategies, a recent Cochrane analysis showed that there was no clear evidence which favors delayed versus immediate (within 24 h of birth) surgical intervention [29]

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