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A schema is a mental construct consisting of a cluster or collection of related concepts (Bartlett, 1932). There are many different types of schemata, and they all have one thing in common: schemata are a method of organizing information that allows the brain to work more efficiently. When a schema is activated, the brain makes immediate assumptions about the person or object being observed.
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Update on Congenital Diaphragmatic Hernia.

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Congenital diaphragmatic hernia (CDH) is a rare defect causing lung issues. Advances in prenatal diagnosis and postnatal care improve outcomes for infants with CDH, including managing pulmonary hypertension.

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Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Anesthesiology

Background:

  • Congenital diaphragmatic hernia (CDH) is a congenital defect where abdominal organs herniate into the chest.
  • This leads to pulmonary hypoplasia and pulmonary hypertension (PH), impacting infant survival.
  • Understanding associated left ventricular (LV) hypoplasia and myocardial dysfunction is crucial.

Purpose of the Study:

  • To provide a comprehensive review of congenital diaphragmatic hernia (CDH) for anesthesiologists.
  • To highlight advances in prenatal diagnosis and fetal therapies for CDH.
  • To discuss optimal postnatal management strategies for CDH.

Main Methods:

  • Review of current literature on CDH pathophysiology, diagnosis, and management.
  • Analysis of advances in prenatal interventions and prognostic factors.
  • Evaluation of postnatal care protocols, including ventilation, nutrition, infection prevention, and PH management.

Main Results:

  • Prenatal diagnosis and identification of prognostic factors have refined fetal therapies for CDH.
  • Protocolized postnatal care, including lung-protective ventilation and aggressive PH management, has improved outcomes.
  • Optimized hemodynamic management, considering LV hypoplasia, aids in PH treatment.

Conclusions:

  • Significant progress in prenatal and postnatal management has improved outcomes for infants with CDH.
  • A multidisciplinary approach is essential for optimizing care.
  • Anesthesiologists play a critical role in managing these complex cases.