Pediatrics: Congenital Diaphragmatic Hernia

Author(s):  
Peggy Wingard

In this chapter the essential aspects of anesthesia for congenital diaphragmatic hernia (CDH) are discussed. Subtopics include respiratory management of CDH patients, airway management, and postoperative considerations of CDH patients. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics addressed are assessment of respiratory and circulatory findings, including pulmonary hypertension. Discussion of intraoperative management includes monitoring, induction using inhalational induction, intubation, and maintenance of the patient, airway management, goals for ventilation, treating possible pneumothorax, and fluids used, such as glucose. Postoperative concerns addressed are decompensation and patient outcome.

1970 ◽  
Vol 7 (1) ◽  
pp. 28-30 ◽  
Author(s):  
SE Khan ◽  
AKMZ Siddiq ◽  
M Nessa

Introduction: Congenital diaphragmatic hernia (CDH) is one of the major surgical causes of respiratory distress in neonates. Reported survival averages 60% but may be significantly lower. Pulmonary hypertension and pulmonary hypoplasia are recognised as two corner stones of the pathophysiology of CDH. Objective: Objective of the study was to evaluate the outcome of this birth defect in Bangladesh situation. Method: This retrospective study was carried out at the Department of Paediatric Surgery of Combined Military Hospital, Dhaka over a period of five years. During this period a total of 8 neonates of CDH were admitted in this hospital. All the data were collected from record sheet and were compiled. Result: Age of patients ranged from 1 day to 20 days. Out of 8 neonates 5 (62.50%) were male and 3 (37.50%) were female. All patients were diagnosed postnatally. All the 8 neonates had Bochdalek type of CDH. Seven patients (87.50%) had left sided hernia. Two patients (25%) died before operation in the stabilization phase while on ventilator and 6 (75%) were operated. Out of these 6 patients, 5 (left sided) were operated through abdominal route and 1 (right sided) was approached through thorax. Overall outcome was satisfactory in 5 neonates and one died. Conclusion: Early intervention can result good prognosis in CDH. Key words: Congenital diaphragmatic hernia; neonate; Bochdalek type DOI: http://dx.doi.org/10.3329/jafmc.v7i1.8623 JAFMC Bangladesh. Vol 7, No 1 (June) 2011; 28-30  


2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Daphne S. Mous ◽  
Marjon J. Buscop-van Kempen ◽  
Rene M. H. Wijnen ◽  
Dick Tibboel ◽  
Robbert J. Rottier

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