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Respiratory Management for the Infant with Congenital Diaphragmatic Hernia

Michelle J Yang1, Matthew Douglass1, Ryan J Carpenter2

  • 1Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine and Primary Children's Hospital, Intermountain Health, Salt Lake City, UT, USA.

Clinics in Perinatology
|June 11, 2026
PubMed

Insights

Congenital diaphragmatic hernia (CDH) requires careful respiratory support. Gentle ventilation strategies are key to minimizing lung injury and improving outcomes for neonates with this complex condition.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Respiratory Physiology

Background:

  • Congenital diaphragmatic hernia (CDH) is a severe neonatal condition.
  • It involves pulmonary hypoplasia and hypertension, necessitating expert respiratory management from birth.
  • Current treatment strategies vary, highlighting a need for refined guidelines.

Purpose of the Study:

  • To synthesize evidence on optimizing respiratory support for CDH.
  • To review current ventilation strategies, from delivery room to postoperative care.
  • To emphasize gentle ventilation to reduce lung injury and improve outcomes.

Main Methods:

  • Review of current evidence and evolving strategies for respiratory support in CDH.
  • Discussion of delivery room resuscitation protocols.
  • Comparative analysis of conventional mechanical ventilation and high-frequency ventilation.

Main Results:

  • Gentle ventilation is crucial for minimizing lung injury in CDH patients.
  • Significant variability exists in current clinical practices for ventilatory management.
  • Advances in respiratory support have been made, but further research is needed.

Conclusions:

  • Optimizing respiratory support, particularly with gentle ventilation, is vital for improving outcomes in CDH.
  • Standardized, evidence-based guidelines are needed to reduce practice variability.
  • High-quality clinical trials are essential to refine management strategies and decrease morbidity and mortality.

Keywords:
Congenital diaphragmatic herniaNon-invasive ventilationPulmonary hypertensionRespiratory managementVentilation

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