Murthy et al reported risk factors for sepsis or urinary tract infection (UTI) in infants with congenital diaphragmatic hernia (CDH). These can help to identify an infant who may benefit from more aggressive management. The authors are from multiple children's hospitals in the United States.
Patient selection: infant with congenital diaphragmatic hernia (CDH)
Risk factors for sepsis or urinary tract infection:
(1) patch or flap repair of hernia (OR 2.8)
(2) congenital anomaly (OR 3.1)
(3) renal malformation (OR 3.9)
where:
• CDH is given as an example of a congenital anomaly in the text.
• A renal malformation is a congenital anomaly.
• Presumably congenital anomaly as an independent risk factor means one other than CDH or renal malformation.
In the abstract duration of central line placement was also listed as a risk factor for bloodstream infection.
Risk factors for mortality,sepsis or urinary tract infection:
(1) admission pH (especially if below 7.15)
(2) not having patch or flap repair of hernia
(3) low birthweight
(4) Apgar < 3 at 5 minutes
(5) need for ECMO
(6) congenital anomaly
(7) renal malformation
