Comparison of early postnatal prediction models for survival in congenital diaphragmatic hernia

Objective To compare the PF-PCO2 equation-partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO(2)) minus partial pressure of carbon dioxide (PCO2)-to three other tools for postnatal prediction of survival in infants with congenital diaphragmatic hernia (CDH). Study design A retrospective analysis of 203 infants with CDH from 1 January 2003 to 30 June 2018. Area under the curve (AUC) analysis was performed for survival and secondary outcomes of survival without extracorporeal membrane oxygenation support (ECMO) and death despite ECMO. Predictive scores were calculated to determine cutoff for PF-PCO2 score. Results The PF-PCO2 tool had the highest AUC (0.84 for survival, 0.92 for survival without ECMO, and 0.83 for death despite ECMO). PF-PCO2 best predicted survival when >-60 and survival without ECMO when >+80. There was no optimal cutoff score for death despite ECMO. Conclusion The PF-PCO2 tool best predicted postnatal survival in infants with CDH.