Abstract
Infants affected with congenital diaphragmatic hernias (CDH) suffer from some degree of respiratory insufficiency arising from a combination of pulmonary hypoplasia and pulmonary hypertension. Respiratory care strategies to optimize blood gasses lead to significant barotrauma, increased morbidity, and overuse of extracorporeal membrane oxygenation (ECMO). Newer permissive hypercapnia/spontaneous ventilation protocols geared to accept moderate hypercapnia at lower peak airway pressures have led to improved outcomes. High-frequency oscillatory ventilation can be used in infants who continue to have persistent respiratory distress despite conventional ventilation. ECMO can be used successfully as a resuscitative strategy to minimize further barotrauma in carefully selected patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 659-668 |
| Number of pages | 10 |
| Journal | Surgical Clinics of North America |
| Volume | 92 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 2012 |
| Externally published | Yes |
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Keywords
- Congenital diaphragmatic hernia
- ECMO
- Lung protective ventilation
- Neonate
ASJC Scopus subject areas
- Surgery
Cite this
Congenital Diaphragmatic Hernia and Protective Ventilation Strategies in Pediatric Surgery. / Garcia, Alejandro; Stolar, Charles J H.
In: Surgical Clinics of North America, Vol. 92, No. 3, 06.2012, p. 659-668.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Congenital Diaphragmatic Hernia and Protective Ventilation Strategies in Pediatric Surgery
AU - Garcia, Alejandro
AU - Stolar, Charles J H
PY - 2012/6
Y1 - 2012/6
N2 - Infants affected with congenital diaphragmatic hernias (CDH) suffer from some degree of respiratory insufficiency arising from a combination of pulmonary hypoplasia and pulmonary hypertension. Respiratory care strategies to optimize blood gasses lead to significant barotrauma, increased morbidity, and overuse of extracorporeal membrane oxygenation (ECMO). Newer permissive hypercapnia/spontaneous ventilation protocols geared to accept moderate hypercapnia at lower peak airway pressures have led to improved outcomes. High-frequency oscillatory ventilation can be used in infants who continue to have persistent respiratory distress despite conventional ventilation. ECMO can be used successfully as a resuscitative strategy to minimize further barotrauma in carefully selected patients.
AB - Infants affected with congenital diaphragmatic hernias (CDH) suffer from some degree of respiratory insufficiency arising from a combination of pulmonary hypoplasia and pulmonary hypertension. Respiratory care strategies to optimize blood gasses lead to significant barotrauma, increased morbidity, and overuse of extracorporeal membrane oxygenation (ECMO). Newer permissive hypercapnia/spontaneous ventilation protocols geared to accept moderate hypercapnia at lower peak airway pressures have led to improved outcomes. High-frequency oscillatory ventilation can be used in infants who continue to have persistent respiratory distress despite conventional ventilation. ECMO can be used successfully as a resuscitative strategy to minimize further barotrauma in carefully selected patients.
KW - Congenital diaphragmatic hernia
KW - ECMO
KW - Lung protective ventilation
KW - Neonate
UR - http://www.scopus.com/inward/record.url?scp=84861009285&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861009285&partnerID=8YFLogxK
U2 - 10.1016/j.suc.2012.03.003
DO - 10.1016/j.suc.2012.03.003
M3 - Review article
C2 - 22595714
AN - SCOPUS:84861009285
VL - 92
SP - 659
EP - 668
JO - Surgical Clinics of North America
JF - Surgical Clinics of North America
SN - 0039-6109
IS - 3
ER -