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Congenital diaphragmatic hernia: current status and review of the literature

Anthony S de Buys Roessingh1, Anh Tuan Dinh-Xuan

  • 1Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011, Lausanne, Switzerland. anthony.debuys-roessingh@Chuv.ch

European Journal of Pediatrics
|December 24, 2008
PubMed

Insights

Congenital diaphragmatic hernia (CDH) treatment is complex. Prenatal tracheal obstruction (TO) and improved postnatal care enhance fetal lung growth and reduce mortality, but challenges remain.

Area of Science:

  • Neonatology
  • Pediatric Surgery
  • Obstetrics

Background:

  • Congenital diaphragmatic hernia (CDH) presents significant challenges in neonatology, pediatric surgery, and obstetrics.
  • High mortality in CDH is linked to persistent pulmonary hypertension (PPHT) and lung hypoplasia, primarily caused by increased pulmonary arteriole muscularization.

Purpose of the Study:

  • To review current management strategies for congenital diaphragmatic hernia.
  • To highlight the impact of prenatal interventions and improved postnatal care on patient outcomes.

Main Methods:

  • Review of current clinical and experimental research on CDH treatment.
  • Analysis of the effects of prenatal tracheal obstruction (TO) and optimized postnatal ventilation.

Main Results:

  • Prenatal TO promotes fetal lung growth, increasing alveoli and capillary vessels.
  • Postnatal care improvements focus on preventing lung injury via low peak inflation pressure ventilation.
  • The efficacy of inhaled nitric oxide and extracorporeal membrane oxygenation (ECMO) remains under debate.

Conclusions:

  • While prenatal interventions and improved postnatal care have advanced CDH management, treatment remains challenging.
  • Further research is needed to establish universally accepted treatment protocols for CDH.

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