Arterial blood gases were measured preoperatively and postoperatively in 20 newborn infants with congenital diaphragmatic hernia during spontaneous breathing or assisted ventilation. Of these 20 patients, 11 survived and 9 died. Arterial blood Pco2 levels of survivors (mean of 44.3 ± 7.9 mm Hg) were significantly lower (p <0.01) than those of nonsurvivors (mean of 61.3±15.4 mm Hg). Arterial blood Po2 levels of survivors (mean of 307.9+142.3) were very significantly higher (p<0.001) than those of nonsurvivors (mean of 49.8±14.2). All but 2 survivors had Po2 levels greater than 230 mm Hg in the preoperative period during breathing of 100% oxygen, while none of those who died had Po2 levels higher than 80 mm Hg. From these results, it is concluded that the prognosis is excellent if the arterial blood Po2 and Pco2 levels are normal preoperatively, or if they can be brought into an acceptable range (Po2 above 230 mm Hg, Pco2 below 70 mm Hg) with oxygen therapy and/or assisted ventilation. On the other hand, if arterial Po2 cannot be raised to the acceptable level by respiratory therapy, a fatal outcome should be anticipated. © 1977 Société Internationale de Chirurgie.
|Journal||World Journal of Surgery|
|Publication status||Published - 1 Nov 1977|