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- Title
Congenital diaphragmatic hernia: current status and review of the literature.
- Authors
Anthony S., De Buys Roessingh; Anh Tuan Dinh-Xuan; de Buys Roessingh, Anthony S; Dinh-Xuan, Anh Tuan
- 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.
- Subjects
DIAPHRAGMATIC hernia; HUMAN abnormalities; PERSISTENT fetal circulation syndrome; MORTALITY; POSTNATAL care; THERAPEUTICS; CALCIUM antagonists; THERAPEUTIC use of enzymes; DIAGNOSIS of fetal diseases; HERNIA treatment; THERAPEUTIC use of nitric oxide; SURFACE active agents; ESTERASES; ANIMALS; ARTIFICIAL respiration; CATHETERIZATION; EXTRACORPOREAL membrane oxygenation; FETAL diseases; GENETIC disorders; GESTATIONAL age; HERNIA; LUNG surgery; COMORBIDITY; TRACHEAL diseases; TREATMENT effectiveness; DIAGNOSIS
- Publication
European Journal of Pediatrics, 2009, Vol 168, Issue 4, p393
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s00431-008-0904-x