Related Experiment Video
Updated: Jun 3, 2026
06:31
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Congenital diaphragmatic hernia: still a moving target
I Sluiter1, C P van de Ven, R M H Wijnen
1Intensive Care, Erasmus MC-Sophia, Rotterdam, The Netherlands.
Seminars in Fetal & Neonatal Medicine
|April 6, 2011
Summary
Congenital diaphragmatic hernia (CDH) management now prioritizes non-operative care by expert teams. While survival improves, long-term multi-organ issues are rising, necessitating further research for optimal treatment strategies.
Area of Science:
- Pediatric Surgery
- Neonatology
- Critical Care Medicine
Background:
- Congenital diaphragmatic hernia (CDH) management has evolved significantly.
- Improved understanding of CDH epidemiology and pathophysiology guides current care.
- Shift from immediate surgical intervention to comprehensive, multidisciplinary newborn emergency management.
Purpose of the Study:
- To review the evolving therapeutic landscape for congenital diaphragmatic hernia.
- To highlight advancements in prenatal diagnosis, postnatal care, and surgical techniques.
- To discuss the implications of decreased mortality on long-term patient morbidity.
Main Methods:
- Review of current therapeutic strategies for CDH.
- Analysis of changes in surgical approaches, including delayed repair and minimally invasive techniques.
- Evaluation of advancements in supportive therapies like ventilation and extracorporeal membrane oxygenation (ECMO).
Main Results:
- Therapeutic focus shifted to non-operative management by interdisciplinary teams.
- Enhanced prenatal diagnosis and postnatal ventilation strategies improve outcomes.
- Delayed surgical repair, minimally invasive surgery, and ECMO are increasingly utilized.
- Decreased mortality rates are observed, but long-term multi-organ morbidity is a growing concern.
Conclusions:
- Current CDH care emphasizes a multidisciplinary, non-operative initial approach.
- Advancements in supportive care and surgical techniques have reduced mortality.
- Increased long-term morbidity necessitates ongoing research and evidence-based practice refinement.
- Future randomized controlled trials are crucial for defining optimal CDH therapeutic pathways.
Related Concept Videos
01:25Hiatal Hernia
A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...
01:08Pneumothorax II: Pathophysiology
Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
01:10Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
01:11Pyloric Obstruction
Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...