부산대학교 도서관

Introduction: Congenital diaphragmatic hernia (CDH) is a serious birth defect characterized by hypoplasia of the pulmonary parenchyma and vascular system. The presence of a ventilation-perfusion ratio (V/Q) mismatch has been demonstrated to be a sensitive predictor of future pulmonary morbidities, such as obstructive pulmonary disease. The present study aims to examine the risk factors associated with V/Q mismatch. Methods: We retrospectively reviewed the clinical course of patients with left CDH in our hospital between 2006 and 2018. During this period, patients with CDH were supposed to undergo lung scintigraphy before discharge routinely. We compared CDH patients with V/Q mismatch to those without from the viewpoint of clinical course, treatment, and complications during the initial hospitalization. Results: There were 114 eligible patients with left CDH; 32 patients were excluded. As a result, 82 patients were analyzed. Fifty-eight patients (71%) had V/Q mismatch, whereas 24 patients (29%) did not. Compared with the no-mismatch group, patients in the mismatch group had an earlier gestational age, lower birthweight, and lower Apgar score at 5 min. There were no differences in Kitano's classification, observed-to-expected lung-to-head ratio, liver herniation, and treatment modality (i.e., patch repair and surfactant). The duration of ventilation (adjusted OR 1.061, 95% CI 1.003–1.122) was significantly longer in the mismatch group adjusted for birthweight. Conclusion: Our data suggested that there was an association between the duration of ventilation and V/Q mismatch before discharge in left CDH patients.