Document Detail

Improving survival of neonates with isolated congenital diaphragmatic hernia.
MedLine Citation:
PMID:  15591664     Owner:  NLM     Status:  MEDLINE    
Despite advances in neonatal care including prenatal diagnosis, conventional ventilation, surfactant, high frequency oscillation, nitric oxide and extracorporeal membrane oxygenation (ECMO) the diagnosis of CDH is reported to carry a high mortality rate. Pulmonary hypoplasia and persistent pulmonary hypertension are major factors that contribute to death. In an effort to improve the survival of these infants a protocolized approach was adopted. In summary, this involves antenatal use of steroids if CDH antenatally diagnosed, sedation and muscle relaxation following tracheal intubation, administration of surfactant, gentle ventilation with permissive hypercapnia, trial of nitric oxide, preoperative ECMO for those infants failing therapy and delayed repair of the CDH. With the use of this protocolized approach the survival of infants with isolated CDH was 96 % for inborn and 81 % for outborn infants.
Horacio C Osiovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian pediatrics     Volume:  41     ISSN:  0019-6061     ISO Abbreviation:  Indian Pediatr     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-13     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  1138-42     Citation Subset:  IM    
Division of Neonatology, British Columbia Children's Hospital, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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MeSH Terms
Clinical Protocols
Extracorporeal Membrane Oxygenation
Hernia, Diaphragmatic / congenital,  mortality*,  therapy*
Infant, Newborn
Intubation, Intratracheal
Prenatal Diagnosis
Pulmonary Surfactants / therapeutic use
Respiration, Artificial
Retrospective Studies
Survival Rate
Treatment Outcome*
Reg. No./Substance:
0/Pulmonary Surfactants

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