Document Detail

Congenital diaphragmatic hernia and protective ventilation strategies in pediatric surgery.
MedLine Citation:
PMID:  22595714     Owner:  NLM     Status:  In-Data-Review    
Infants affected with congenital diaphragmatic hernias (CDH) suffer from some degree of respiratory insufficiency arising from a combination of pulmonary hypoplasia and pulmonary hypertension. Respiratory care strategies to optimize blood gasses lead to significant barotrauma, increased morbidity, and overuse of extracorporeal membrane oxygenation (ECMO). Newer permissive hypercapnia/spontaneous ventilation protocols geared to accept moderate hypercapnia at lower peak airway pressures have led to improved outcomes. High-frequency oscillatory ventilation can be used in infants who continue to have persistent respiratory distress despite conventional ventilation. ECMO can be used successfully as a resuscitative strategy to minimize further barotrauma in carefully selected patients.
Alejandro Garcia; Charles J H Stolar
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Publication Detail:
Type:  Journal Article     Date:  2012-04-26
Journal Detail:
Title:  The Surgical clinics of North America     Volume:  92     ISSN:  1558-3171     ISO Abbreviation:  Surg. Clin. North Am.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0074243     Medline TA:  Surg Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  659-68     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Pediatric Surgery, Columbia University College of Physicians and Surgeons, 3959 Broadway, CHN 214, New York, NY 10032, USA.
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