Association between vasoactive-inotropic score, clinical outcomes, defect size and laterality in congenital diaphragmatic hernia.

OBJECTIVE

To assess whether vasoactive-inotropic score (VIS) during early life was predictive of outcomes for infants with congenital diaphragmatic hernia and to determine whether VIS differed by defect size and laterality.

STUDY

DESIGN

Retrospective single-center cohort study of 206 infants with CDH. VIS was calculated at 6, 12, 24, 48 and 72 h of life as well as at repair, 24 h and 48 h-post repair.

RESULT: Higher VIS scores at all time points were associated with an increased risk of mechanical ventilation at 28 days of life (p < 0.02). VIS in the first 24 h was associated with an increased risk ECMO or death (p < 0.001) and tracheostomy or death (p < 0.02). VIS did not differ between left and right defects, but larger defects had higher scores.

CONCLUSION

Early-life VIS scores at 6, 12 and 24 h have predictive value for extended duration of mechanical ventilation, ECMO, tracheostomy or death.