To determine the appropriate initial ventilatory mode for neonatal congenital diaphragmatic hernia (CDH) by comparing patient prognosis following conventional mechanical ventilation (CMV) versus high-frequency oscillatory ventilation (HFO).
This multicenter retrospective cohort study was performed at 15 participating hospitals in Japan between 2011 and 2016. The 328 eligible CDH infants were classified into CMV (n = 78) and HFO groups (n = 250) to compare mortality and incidence of bronchopulmonary dysplasia (BPD). Propensity score matching was applied to reduce confounding by indication.
While crude mortality was significantly higher in the HFO than the CMV group, adjusted odds ratio (OR) did not show significant difference in mortality between groups (OR of HFO group: 0.98, 95% confidence interval (CI): 0.57–1.67). Adjusted OR of BPD incidence showed no significant difference between groups (OR of HFO group: 1.66, 95%CI: 0.50–5.49).
Initial ventilatory mode in CDH patients, whether CMV or HFO, does not affect prognosis.
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The authors thank all the members of the Japanese CDH Study Group and all the participant institutes in this study.
The Japanese Congenital Diaphragmatic Hernia Study Group
Hiroomi Okuyama17, Noriaki Usui3, Tomoaki Taguchi4, Masahiro Hayakawa5, Kouji Masumoto6, Yutaka Kanamori7, Shoichiro Amari8, Naoto Urushihara9, Noboru Inamura10, Akiko Yokoi11, Tadaharu Okazaki12,13, Katsuaki Toyoshima14, Taizou Furukawa15, Keita Terui16, Satoko Ohfuji2, Yuko Tazuke17, Keiichi Uchida18, Genshiro Esumi19, Jyunya Oomura20, Manabu Okawada12, Kohei Sakai15, Takuya Kondo21, Toshiharu Matsuura21, Kouji Motokura22, Motoyoshi Kawataki14, Kaoru Katsumata14, Mikihiro Inoue23, Kouji Nagata24, Miharu Ito25, Ryousuke Miura5, Kazuhito Ueda5, Yoshiaki Sato5, Akiko Saitou5, Yukako Muramatsu5, Shinobu Sekimoto5, Yasuhisa Ikuta8, Yuichi Takama17, Ryuta Saka17, Ayako Matsuura17, Yasuji Kitabatake26, Hidetoshi Taniguchi27, Muneyuki Takeuchi28, Atsushi Kawamura28, Narutaka Mochizuki29, Makiko Fuyuki1,2, Masaya Yamoto9, Koji Fukumoto9, Yui Ueda30, Hajime Takayasu6, Yasuhisa Urita6, Sasagu Kimura31
This work was supported by the Japan Agency for Medical Research and Development under Grant Number JP19ek0109264s1303.
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Members of the Japanese Congenital Diaphragmatic Hernia Study Group are listed below Acknowledgements.
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Fuyuki, M., Usui, N., Taguchi, T. et al. Prognosis of conventional vs. high-frequency ventilation for congenital diaphragmatic hernia: a retrospective cohort study. J Perinatol (2020). https://doi.org/10.1038/s41372-020-00833-6