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[Results of treatment of newborn infants with diaphragmatic hernias]
Insights
Improved diagnostics and altered resuscitation tactics for congenital diaphragmatic hernias in newborns significantly reduced mortality by 50% over 30 years.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Malformations
Context:
- Review of 91 newborns treated for diaphragmatic hernias between 1955 and 1985.
- Enhanced diagnostic capabilities led to earlier admission of neonates.
Purpose:
- To analyze the frequency and nature of postoperative complications.
- To identify causes of complications and effective preventive measures.
- To evaluate changes in resuscitation tactics and their impact on lethality.
Summary:
- Treatment strategies evolved, including changes in artificial lung ventilation and the use of Tubarin and Dopamine.
- Postoperative complications and mortality patterns were systematically reviewed.
- Lethality rates were reduced by twofold through updated management protocols.
Impact:
- Demonstrates the significant impact of improved diagnostics and advanced resuscitation on reducing mortality in neonatal diaphragmatic hernia cases.
- Provides insights into effective strategies for managing postoperative complications.
- Highlights the importance of adapting medical interventions based on evolving clinical experience and technology.
Abstract:
The article generalizes an experience with the treatment of 91 newborns with diaphragmatic hernias for the period from 1955 to 1985. The diagnostics has improved and greater amount of newborns were admitted to the clinic within the first day after birth. The frequency and character of postoperative complications were analyzed as well as causes of their appearance and effective measures for their prevention and structure of lethality. The tactics of resuscitation both before and after operation has been changed: the artificial ventilation of the lungs was performed without a positive pressure at the end of the expiration with the use of Tubarin and infusion of Dopamine. Lethality was 2 times reduced.