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DOI: 10.1055/s-0037-1606221
Outcome Analysis of Congenital Diaphragmatic Hernia Cohort before and after Implementation of Standardized Protocol in a Tertiary Neonatal Unit
Publikationsverlauf
15. November 2016
11. Juli 2017
Publikationsdatum:
24. August 2017 (online)

Abstract
Despite evolving evidence and increased understanding, there is a strong argument that best outcomes in managing congenital diaphragmatic hernia (CDH) patients are achieved in centers which have a high admission rate of such patients and follow standardized operating protocols of management. Pneumothorax and air leak syndromes are one of the main causes of pre- and postoperative morbidity in these patients and experts believe that delivery room sedation and gentle ventilation strategies can minimize this. We observed a significant drop in incidence of pneumothorax and reduction of mortality following implementation of standardized guidelines at the neonatal unit at Southampton which is a tertiary-level neonatal care in the southern United Kingdom and a regional referral center for CDH patients.
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References
- 1 Clark RH, Hardin Jr WD, Hirschl RB. , et al. Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg 1998; 33 (07) 1004-1009
- 2 Javid PJ, Jaksic T, Skarsgard ED, Lee S. ; Canadian Neonatal Network. Survival rate in congenital diaphragmatic hernia: the experience of the Canadian Neonatal Network. J Pediatr Surg 2004; 39 (05) 657-660
- 3 Al-Hathlol K, Elmahdy H, Nawaz S. , et al. Perioperative course of pulmonary hypertension in infants with congenital diaphragmatic hernia: impact on outcome following successful repair. J Pediatr Surg 2011; 46 (04) 625-629
- 4 Boloker J, Bateman DA, Wung JT, Stolar CJH. Congenital diaphragmatic hernia in 120 infants treated consecutively with permissive hypercapnea/spontaneous respiration/elective repair. J Pediatr Surg 2002; 37 (03) 357-366
- 5 Migliazza L, Bellan C, Alberti D. , et al. Retrospective study of 111 cases of congenital diaphragmatic hernia treated with early high-frequency oscillatory ventilation and presurgical stabilization. J Pediatr Surg 2007; 42 (09) 1526-1532
- 6 Finer NN, Etches PC, Kamstra B, Tierney AJ, Peliowski A, Ryan CA. Inhaled nitric oxide in infants referred for extracorporeal membrane oxygenation: dose response. J Pediatr 1994; 124 (02) 302-308
- 7 Osiovich HC. Improving survival of neonates with isolated congenital diaphragmatic hernia. Indian Pediatr 2004; 41 (11) 1138-1142
- 8 Usui N, Nagata K, Hayakawa M. , et al. Pneumothoraces as a fatal complication of congenital diaphragmatic hernia in the era of gentle ventilation. Eur J Pediatr Surg 2014; 24 (01) 31-38
- 9 Danzer E, Gerdes M, D'Agostino JA. , et al. Longitudinal neurodevelopmental and neuromotor outcome in congenital diaphragmatic hernia patients in the first 3 years of life. J Perinatol 2013; 33 (11) 893-898
- 10 D'Agostino JA, Bernbaum JC, Gerdes M. , et al. Outcome for infants with congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation: the first year. J Pediatr Surg 1995; 30 (01) 10-15
- 11 Van Meurs KP, Robbins ST, Reed VL. , et al. Congenital diaphragmatic hernia: long-term outcome in neonates treated with extracorporeal membrane oxygenation. J Pediatr 1993; 122 (06) 893-899
- 12 Cortes RA, Keller RL, Townsend T. , et al. Survival of severe congenital diaphragmatic hernia has morbid consequences. J Pediatr Surg 2005; 40 (01) 36-45 , discussion 45–46
- 13 Snoek KG, Reiss IK, Greenough A. , et al; CDH EURO Consortium. Standardized Postnatal Management of Infants with Congenital Diaphragmatic Hernia in Europe: The CDH EURO Consortium Consensus - 2015 Update. Neonatology 2016; 110 (01) 66-74
- 14 Mohseni-Bod H, Bohn D. Pulmonary hypertension in congenital diaphragmatic hernia. Semin Pediatr Surg 2007; 16 (02) 126-133