論文

査読有り 国際誌
2020年6月

Risk factors for pneumothorax associated with isolated congenital diaphragmatic hernia: results of a Japanese multicenter study.

Pediatric surgery international
  • Kazunori Masahata
  • ,
  • Noriaki Usui
  • ,
  • Kouji Nagata
  • ,
  • Keita Terui
  • ,
  • Masahiro Hayakawa
  • ,
  • Shoichiro Amari
  • ,
  • Kouji Masumoto
  • ,
  • Tadaharu Okazaki
  • ,
  • Noboru Inamura
  • ,
  • Naoto Urushihara
  • ,
  • Katsuaki Toyoshima
  • ,
  • Keiichi Uchida
  • ,
  • Taizo Furukawa
  • ,
  • Manabu Okawada
  • ,
  • Akiko Yokoi
  • ,
  • Hiroomi Okuyama
  • ,
  • Tomoaki Taguchi

36
6
開始ページ
669
終了ページ
677
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00383-020-04659-3

PURPOSE: This study aimed to elucidate the clinical characteristics of neonates with congenital diaphragmatic hernia (CDH) associated with pneumothorax and evaluate the risk factors for the development of pneumothorax. METHODS: A retrospective cohort study was conducted in the 15 institutions participating in the Japanese CDH Study Group. A total of 495 neonates with isolated CDH who were born between 2011 and 2018 were analyzed in this study. RESULTS: Among the 495 neonates with isolated CDH, 52 (10.5%) developed pneumothorax. Eighteen (34.6%) patients developed pneumothorax before surgery, while 34 (65.4%) developed pneumothorax after surgery. The log-rank test showed that the cumulative survival rate was significantly lower in patients with pneumothorax than in those without pneumothorax. Univariate analysis revealed significant differences between patients with pneumothorax and those without pneumothorax with regard to the best oxygenation index within 24 h after birth, mean airway pressure (MAP) higher than 16 cmH2O, diaphragmatic defect size, and need for patch closure. Multiple logistic regression analysis indicated that only the MAP was associated with an increased risk of pneumothorax. CONCLUSIONS: The cumulative survival rate was significantly lower in isolated CDH patients with pneumothorax than in those without pneumothorax. A higher MAP was a risk factor for pneumothorax in CDH patients.

リンク情報
DOI
https://doi.org/10.1007/s00383-020-04659-3
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32346849

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