Evolving management of congenital diaphragmatic hernia

Brown, Richard N; Bösenberg, Adrian

doi:10.1111/j.1460-9592.2007.02253.x

Cited by 16 publications

(6 citation statements)

References 40 publications

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“…More than 90% of the International CDH Registry centres aimed to minimise lung injury by limiting the peak airway pressure and allowing permissive hypercapnia, rather than aiming for a low Pa,CO 2 to reduce pulmonary vascular resistance [50]. Some centres routinely use neuromuscular blocking agents, whereas others avoid them [51], as muscle paralysis may have an adverse effect on ventilation [49]. Indications for alternative forms of support (high-frequency oscillation ventilation (HFOV), inhaled nitric oxide (iNO) and ECMO) are a pH of ,7.25, Pa,CO 2 .60 mmHg and preductal oxygen saturation less than 80-85% with an inspired oxygen concentration of 60% [52].…”

Section: Post-natal Management Of Cdh Venue and Timing Of Deliverymentioning

confidence: 99%

Congenital diaphragmatic hernia

Kotecha¹,

Barbato²,

Bush³

et al. 2011

Eur Respir J

140

122

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Infants with congenital diaphragmatic hernia (CDH) have significant mortality and long-term morbidity. Only 60-70% survive and usually those in high-volume centres. The current Task Force, therefore, has convened experts to evaluate the current literature and make recommendations on both the antenatal and post-natal management of CDH. The incidence of CDH varies from 1.7 to 5.7 per 10,000 live-born infants depending on the study population. Antenatal ultrasound scanning is routine and increasingly complemented by the use of magnetic resonance imaging. For isolated CDH, antenatal interventions should be considered, but the techniques need vigorous evaluation. After birth, management protocols are often used and have improved outcome in nonrandomised studies, but immediate intubation at birth and gentle ventilation are important. Pulmonary hypertension is common and its optimal management is crucial as its severity predicts the outcome. Usually, surgery is delayed to allow optimal medical stabilisation. The role of minimal invasive post-natal surgery remains to be further defined. There are differences in opinion about whether extracorporeal membrane oxygenation improves outcome. Survivors of CDH can have a high incidence of comorbidities; thus, multidisciplinary follow-up is recommended. Multicentre international trials are necessary to optimise the antenatal and post-natal management of CDH patients.

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Section: Post-natal Management Of Cdh Venue and Timing Of Deliverymentioning

confidence: 99%

Congenital diaphragmatic hernia

Kotecha¹,

Barbato²,

Bush³

et al. 2011

Eur Respir J

140

122

View full text Add to dashboard Cite

show abstract

“…Por desgracia, la detección depende de la experiencia, la técnica y las habilidades del operador, La detección temprana oscila entre 50 a 60%, generalmente a menor edad gestacional se haga el diagnostico peor pronóstico (37)(38)(39).…”

Section: Análisis Y Discusiónunclassified

Eventración Diafragmática en Niños, Reporte De Un Caso Y Revisión De Tema.

Pérez

2015

Revisalud

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Introducción: La eventración diafragmática es un cuadro muy poco frecuente en niños, que puede cursar en forma asintomática o con manifestaciones respiratorias bajas o gastrointestinales y cuyo diagnóstico podría ser casual, al solicitar imágenes para comprobar una sospecha diagnóstica: Puede ser de causa congénita o adquirida y su tratamiento depende de los síntomas. Desarrollo: Se presenta un recorrido desde la practica por los aspectos con mayor relevancia en cuanto a una patología infrecuente, presentándose caso clínico de una escolar de 8 años de edad con EVENTRACION DIAFRAGMATICA (ED) sucedido en el Hospital Infantil Napoleón Franco Pareja (HINFP de Cartagena Colombia) con radiografía de tórax que muestra elevación de hemidiafragma derecho. El paciente cursaba asintomático al momento de la consulta y el diagnóstico fue casual con imágenes tomadas un mes antes de la consulta para descartar una infección respiratoria baja que cedió. Conclusiones: Los hallazgos y la evolución clínica de esta patología se relacionan con complicaciones como infección pulmonar crónica, ruptura diafragmática, úlceras y vólvulos de estómago en baja frecuencia. El tratamiento es un tema discutido, no se considera intervenir quirúrgicamente si el paciente está asintomático y sólo se realizan plicatura a los pacientes sintomáticos. El pronóstico de esta patología es bueno.

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“…Patients commonly present in the neonatal period with respiratory distress and in some cases cyanosis, however, 10% present later in life. [ 5 6 ] We present a case series of anesthetic management of CDH with video-assisted thoracoscopic surgery (VATS).…”

Section: Introductionmentioning

confidence: 99%

Case series on anesthesia for video-assisted thoracoscopic surgery for congenital diaphragmatic hernia in children

2016

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Video-assisted thoracoscopic surgery (VATS) in the pediatric population is a challenging task for any anesthesiologist, moreover considering the high incidence of associated congenital anomalies which are individual predictors of poor prognosis. A thorough preoperative evaluation, knowledge of the physiology of one lung ventilation - pertaining to various methods of lung isolation, individualized meticulous planning, and continuous vigilance to detect any untoward event at the earliest with good communication between the anesthesiology and surgical teams contributes to a safe and successful surgery. We present a case series of anesthetic management of congenital diaphragmatic hernia with VATS.

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Evolving management of congenital diaphragmatic hernia

Cited by 16 publications

References 40 publications

Congenital diaphragmatic hernia

Congenital diaphragmatic hernia

Eventración Diafragmática en Niños, Reporte De Un Caso Y Revisión De Tema.

Case series on anesthesia for video-assisted thoracoscopic surgery for congenital diaphragmatic hernia in children

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