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Updated: Aug 21, 2026
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
[Treatment of congenital diaphragmatic hernia in neonates]
1Klinika dĕtské chirurgie 2. LF UK a FNM a subkatedra dĕtské chirurgie IPVZ, Praha. pychovi@yahoo.com
Insights
Congenital Diaphragmatic Hernia (CDH) treatment in neonates has high mortality. This study presents a protocol improving survival rates for CDH patients, emphasizing early diagnosis and specialized care.
Area of Science:
- Neonatal Surgery
- Pediatric Surgery
- Congenital Malformations
Context:
- Congenital Diaphragmatic Hernia (CDH) presents significant mortality risks in neonates with early symptoms.
- Effective treatment protocols are crucial for improving outcomes in affected newborns.
Purpose:
- To present a treatment protocol for neonates diagnosed with Congenital Diaphragmatic Hernia (CDH).
- To evaluate the outcomes and survival rates associated with the implemented CDH treatment protocol between 1994 and 2003.
Summary:
- A total of 96 neonates with CDH were treated, with 30% diagnosed prenatally. The protocol involved stabilization, surgery (laparotomy or ECMO), early extubation, and nutrition.
- Overall survival was 74%. Survival rates varied: 91% for surgically treated, 75% for those with Goretex patches, and 40% for those requiring ECMO. Relapse was rare (1%).
Impact:
- The study highlights the importance of prenatal diagnosis and centralized care in specialized centers with ECMO capabilities.
- Improved management strategies can significantly enhance the prognosis for neonates with Congenital Diaphragmatic Hernia.
Background:
Treatment of the Congenital Diaphragmatic Hernia in neonates with early manifestations has been accompanied with significant mortality. Authors present the treatment protocol employed in such children and results from the period January 1994 to December 2003.
Methods And Results:
Since January 1994 to December 2003 96 children were cured for the Congenital Diaphragmatic Hernia. Ratio F:M was 36:60. 29 children (30%) were diagnosed prenatally, the remaining newborns were diagnosed on the basis of thoracic X-ray, which was required for the early signs of respiratory insufficiency. The postnatal treatment protocol included circulation-ventilation stabilisation, operation, early extubation and initiation of the peroral nourishment. Altogether 78 (81%) of children were operated after the stabilization using the standard laparotomy method, 5 children (6%) were operated with extra corporal membrane oxygenation, in 20 children (26%) a Goretex patch was used to cover an extensi e defect in the diaphragm. Overall survival was 74%, survival of operated children was 91%, 75% of children with a patch survived, survival of children operated with ECMO was 40%. Relapse occurred in one child (1%) with a patch.
Conclusions:
Specification of the prenatal diagnosis and collection of patients with CDH into tertiary centres with ECMO possibility can improve prognosis of neonates with the malformation.
