Improving survival in the treatment of XXXX .

@entity1 @entity4388 @entity2914 @entity33711 @entity2507 @entity299
Thirty-two @entity1 were treated for @entity2914 at our institution from 1979 to 1984. Eight were in no or minimal distress at birth and had operative intervention when they were more than 24 hours old; survival was 100%. The remaining 24 neonates required immediate intubation and ventilation followed by operation at less than 12 hours of age. Overall survival was 54%; survival was 31% (4 of 13 @entity1 , Group 1) in the first three years of the series and 82% (9 of 11 @entity1 , Group 2) in the last three years (p less than 0.001). Apgar score, gestational age, birth weight, and incidence of associated @entity299 were equal for the two groups (all, p greater than 0.05). The two groups also were examined with reference to alveolar-arterial oxygen differences P(A-a)O2 and mean airway pressure (MAP). The best preoperative P(A-a)O2 was greater than 600 mm Hg for 7 neonates in Group 1 and 6 in Group 2, and survival was 0% and 71%, respectively (p less than 0.001). @entity1 with a postoperative MAP of 13 cm @entity2507 or greater had a higher mortality (100% in Group 1 and 50% in Group 2, p greater than 0.05). Our treatment protocol was studied to determine those methods related to improved survival. @entity4388 infusion was used earlier in Group 2 as a prophylaxis against @entity33711 ( @entity33711 ) (p greater than 0.05). The incidence of severe @entity33711 dropped from 85 to 54% (p greater than 0.05). Higher ventilator rates rather than pressures were used to achieve equally effective ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)
