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Published in: European Journal of Pediatrics 4/2009

01-04-2009 | Review

Congenital diaphragmatic hernia: current status and review of the literature

Authors: Anthony S. de Buys Roessingh, Anh Tuan Dinh-Xuan

Published in: European Journal of Pediatrics | Issue 4/2009

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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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Metadata
Title
Congenital diaphragmatic hernia: current status and review of the literature
Authors
Anthony S. de Buys Roessingh
Anh Tuan Dinh-Xuan
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 4/2009
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-008-0904-x

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