Ventilator strategies in congenital diaphragmatic hernia.

Semin Pediatr Surg

Division of Neonatology, Primary Children's Medical Center, University of Utah Health, USA.

Published: August 2024

AI Article Synopsis

  • - This review examines current mechanical ventilator practices for managing neonates with congenital diaphragmatic hernia (CDH), highlighting both conventional and unconventional ventilation methods.
  • - It emphasizes the importance of gentle ventilation approaches and discusses clinical guidelines based on evidence to support the care of these vulnerable infants.
  • - Additionally, the review explores the relationship between CDH lung hypoplasia and related cardiopulmonary issues, while also suggesting future research directions for mechanical ventilation in CDH cases.

Article Abstract

This review focuses on contemporary mechanical ventilator practices used in the initial management of neonates born with congenital diaphragmatic hernia (CDH). Both conventional and non-conventional ventilation modes in CDH are reviewed. Special emphasis is placed on the rationale for gentle ventilation and the current evidence-based clinical practice guidelines that are recommended for supporting these fragile infants. The interplay between CDH lung hypoplasia and other key cardiopulmonary elements of the disease, namely a reduced pulmonary vascular bed, abnormal pulmonary vascular remodeling, and left ventricular hypoplasia, are discussed. Finally, we provide insights into future avenues for mechanical ventilator research in CDH.

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Source
http://dx.doi.org/10.1016/j.sempedsurg.2024.151439DOI Listing

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