Does a highest pre-ductal O 2 saturation <85% predict non-survival for congenital diaphragmatic hernia?

Objective:to analyze operative repair, extracorporeal membrane oxygenation (ecmo) and survival rates based on highest pre-ductal oxygen saturation (pre-o2sat) in a large infant cohort reported to congenital diaphragmatic hernia study group registry between 2000 and 2010.study design:analyzed data included gestational age, birth weight, defect side and size, repair, ecmo use, survival and highest reported pao2 and pre-o2sat in first 24 h of life. we excluded 614 infants due to severe anomaly. pre-o2sat data were available for 1672 infants.result:among infants with highest pre-o2sat value <85%, survival (24/105=23%) and repair (55/105=52%) rates were significantly decreased compared with infants with higher values. survival increased to 44% for infants with highest pre-o2sat<85% who underwent operative repair. of these, 83% (20/24) required ecmo support compared with 15% (144/961) of survivors with pre-o2sat>99% (p<0.001). the lowest reported pre-o2sat with survival was 32% and for survival without ecmo was 52%.conclusion:a reported highest pre-o2sat<85% in the first 24 h of life was not uniformly fatal; but survival of infants with pre-o2sat<85% was associated with high ecmo use and prolonged hospitalization.