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Title of Journal: Eur J Pediatr

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Abbravation: European Journal of Pediatrics

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Springer-Verlag

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10.1016/0378-1119(92)90371-U

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1432-1076

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Congenital diaphragmatic hernia current status an

Authors: Anthony S de Buys Roessingh Anh Tuan DinhXuan
Publish Date: 2008/12/23
Volume: 168, Issue: 4, Pages: 393-
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Abstract

Treatment of congenital diaphragmatic hernia CDH challenges obstetricians pediatric surgeons and neonatologists Persistent pulmonary hypertension PPHT associated with lung hypoplasia in CDH leads to a high mortality rate at birth PPHT is principally due to an increased muscularization of the arterioles Management of CDH has been greatly improved by the introduction of prenatal surgical intervention with tracheal obstruction TO and by more appropriate postnatal care TO appears to accelerate fetal lung growth and to increase the number of capillary vessels and alveoli Improvement of postnatal care over the last years is mainly due to the avoidance of lung injury by applying low peak inflation pressure during ventilation The benefits of other drugs or technical improvements such as the use of inhaled nitric oxide or extracorporeal membrane oxygenation ECMO are still being debated and no single strategy is accepted worldwide Despite intensive clinical and experimental research the treatment of newborn with CDH remains difficult

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