Letters to the Editor

Indian Pediatrics 2003; 40:920

Modified Ventilatory Index (MVI) in Newborns with Congenital Diaphragmatic Hernia (CDH)

Many methods and indexes are used to determine the prognosis in newborns with CDH(1-4). MVI is also used with this purpose. We evaluated 30 newborns with CDH to evaluate the utility of MVI in prognosticating these cases. MVI was calculated by using the formula: (PIP × respiratory rate × PaCO2)/1000). Newborns with CDH who did not undergo mechanical ventilation were excluded. Out of thirty newborns (22 boys and 8 girls), 14 newborns (46.7%) died and the rest could be discharged. The mean birth weight was 2865 g (2050-3790). The MVI scores were 43.7 ± 16.2 in survivors; and 94.9 ± 29.7 in non-survivors (P <0.05). All newborns with a MVI score over 80 died. MVI over 80 predicted no chance of survival, with a sensitivity and specificity of 100%. MVI score less than 60 predicted a 100% chance of survival, with a sensitivity of 97% and a specificity of 100%. The present study demonstrated, that the prognosis was good in patients with MVI score less than 60, and poor with MVI scores more than 80. Newborns with probability of good prognosis were operated at a mean age of 28 hours. All patients underwent primary repair, without any need of a prosthetic patch. They were extubated on the 2nd day and were discharged at a mean age of 7.4 days.

Zekeriya Ilce,
Sinan Celayir,
Department of Pediatric Surgery,
Cerrahpasa Medical Faculty,
University of Istanbul-Turkey.
E-mail: [email protected], [email protected]

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