Congenital heart disease and congenital diaphragmatic hernia: the role of intracardiac shunts.

OBJECTIVE

To evaluate the impact of cardiac lesions on outcomes to discharge in infants with congenital diaphragmatic hernia (CDH).

STUDY

DESIGN

Retrospective analysis of infants with CDH identified in the Children's Hospitals Neonatal Database (CHND) from 2010 to 22. Patients were stratified into groups based on associated congenital heart disease (CHD): (1) noCHD (2) CDH + atrial, ventricular septal defects (avCHD); (3) CDH + severe CHD (sevCHD).

RESULTS

Among 2940 neonates with CDH, 570 (19%) had CHD (453 avCDH, 117 sevCHD). CHD of any severity was associated with small for gestational age at birth, a 5 minute Apgar <5, and additional anomalies or syndromes (p < 0.05 for all). Mechanical ventilation days, use of extra-corporeal membrane oxygenation, length of stay, and mortality increased with CHD severity (p < 0.005). Home medical needs were more frequent in infants with associated CHD (p < 0.001).

CONCLUSIONS

Comorbid CHD of any severity adds complexity and risk to patients with CDH.