Congenital Diaphragmatic hernia – a review

摘要: Congenital Diaphragmatic hernia (CDH) is a condition characterized by defect in the diaphragm leading to protrusion of abdominal contents into thoracic cavity interfering with normal development lungs. The may range from small aperture posterior muscle rim complete absence diaphragm. pathophysiology CDH combination lung hypoplasia and immaturity associated persistent pulmonary hypertension newborn (PPHN) cardiac dysfunction. Prenatal assessment head ratio (LHR) position liver ultrasound are used diagnose predict outcomes. Delivery infants recommended close term gestation. Immediate management at birth includes bowel decompression, avoidance mask ventilation endotracheal tube placement if required. main focus gentle ventilation, hemodynamic monitoring treatment followed surgery. Although inhaled nitric oxide not approved FDA for PPHN induced CDH, it commonly used. Extracorporeal membrane oxygenation (ECMO) typically considered after failure conventional medical infants ≥ 34 weeks’ gestation or weight >2 kg no major lethal anomalies. Multiple factors such as prematurity, abnormalities, severity PPHN, type repair need ECMO can affect survival an infant CDH. With advances overall has improved been reported be 70-90% non-ECMO up 50% who undergo ECMO.