Clinical outcomes and protocol for the management of isolated congenital diaphragmatic hernia based on our prenatal risk stratification system

ECMO utilization in infants with congenital diaphragmatic hernia in the USA

“… 20–22 Furthermore, the increasing implementation of standardized, risk-adjusted management protocols may have impacted the outcomes of infants with CDH. 23 24 Advancements in prenatal diagnostic evaluations, such as lung-to-head ratio (LHR) and observed-to-expected total lung volume (o/e TLV), also may have lowered ECMO utilization in the neonatal CDH population. Advancements in fetal diagnosis and assessment of lung volumes by ultrasound and fetal MRI in CDH infants allows for improved prepartum and peripartum planning, such as an arrangement of delivery at a tertiary or quaternary center, and for better preparation of healthcare teams and resource mobilization.…”

Development of mortality prediction models for infants with isolated, left‐sided congenital diaphragmatic hernia before and after birth

“…A precise severity assessment would also be beneficial to the risk-adjusted analysis of CDH to develop and evaluate treatment strategies. 25 Postnatal echocardiography to assess pulmonary hypertension may enhance the predictive ability, although the missing rates made our evaluation unfeasible. A prospective study involving postnatal echocardiography findings and long-term prognoses is urgently needed and is currently underway.…”

“…Reportedly, the most difficult challenge for parents of infants with CDH is the management of insecurities, 40 which can be eased by repetitive counseling with accurate prognostic predictions during each stage. A precise severity assessment would also be beneficial to the risk‐adjusted analysis of CDH to develop and evaluate treatment strategies 25 . Postnatal echocardiography to assess pulmonary hypertension may enhance the predictive ability, although the missing rates made our evaluation unfeasible.…”

“…Predicting mortality for individual infants would help clinicians inform the individuals' parents or guardians before and after birth, select suitable patients for fetal treatment (such as fetoscopic endotracheal occlusion [FETO]), and develop postnatal strategies, including palliative care. [23][24][25] Therefore, this study aimed to develop prenatal and postnatal mortality prediction models for infants with isolated, left-sided CDH based on the optimal combination of predictors using a nationwide database and statistical machine learning methods.…”

Successful surgical correction of right&sided congenital diaphragmatic hernia with critical pulmonary hypoplasia

“…Так, більшість дос лідників визначають ступінь гіпоплазії легень як надійний прогностичний критерій виживання в періоді новонародженості. Зі значної кількості запропонованих методів пренатального визна чення об'єму легень найбільш рекомендованими є О/Е LHR (Observed to expected lung area to head circumference ratio), (причому при лівобіч ній ПДГ про поганий прогноз свідчить значення <25%, а при правобічній -<45%), PPLV [7], а також LHR, LTR [11]. Нами запропоновано оригінальні критерії, що разом із традиційними дають змогу точніше визначити ступінь гіпопла зії легень та розробити тактику надання хірур гічної допомоги новонародженим із ПДГ [24].…”