Congenital Diaphragmatic Hernia

Sunita Goel
Management In Delivery Room And NICU
- Intubate. Avoid ventilation with Ambu bag or mask due to risk of gastric distention, which will further compromise respiratory and cardiac function
- Positive Pressure Ventilation(see Table 2). Hyperventilation. Maintain pH > 7.5. Peak inspiratory pressure < 30 cm H2O (watch for pneumothorax). High frequency ventilation
- Passage of NG tube to decompress stomach
- IV access and fluid resuscitation

Factors Contributing to Lung Injury in PPV (Table 2)

Factors Contributing to Lung Injury in PPV

Extracorporeal Membrane Oxygenation: Current guidelines are unclear.

Aims of therapy:
- To limit airway pressure and oxygen toxicity
- To eliminate shunting
- To reverse systemic hypoxemia
- To reduce pulmonary blood flow
- To allow gradual expansion of lung

Problems with ECMOProblems with ECMO:
- Technical complications in 20% of patients
- Tubing rupture or disconnection
- Clotting disorders
- Air embolism
- Oxygenator failure
- Heat exchanger malfunction
- Power failure
- Malpositioning of cannula
- Inadvertent decannulation
- 10% human error
- Open air entry port (potentially fatal)
- Blood loss due to disconnection
- Extremely labor intensive (12 to 34 ECMO specialists recommended)

Surgical Repair with Gore-Tex patch

Congenital Diaphragmatic Hernia

Congenital Diaphragmatic Hernia

Early vs Late Repair: There is no difference in survival ( 75% versus 72%)

Congenital Diaphragmatic Hernia Congenital Diaphragmatic Hernia 12/31/2001
<< Chest X Ray Findings Long Term Survival and Morbidity >>
ask a doctor
Ask a Doctor
Disclaimer: The information given by is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0