Congenital Diaphragmatic Hernia

Abstract

Despite significant advances in the treatment of congenital malformations in newborns, there is still a fairly high mortality rate in the group of newborns with congenital diaphragmatic hernia. This fact is associated with the high incidence of concomitant pulmonary hypertension in newborns with lung hypoplasia due to compression by organs that have invaded the chest cavity [1]. In the early 2000s, the mortality rate in congenital diaphragmatic hernia in newborns was approximately 30%. With the introduction of delayed surgery tactics in recent years, survival has improved in the group of infants with hypertension in the pulmonary circulation. The main decisive moments for stabilizing a newborn with congenital diaphragmatic hernia and reducing the degree of pulmonary hypertension are the early transfer of the patient to machine breathing in high-frequency ventilation mode, adherence to the temperature regime, minimization of invasive procedures, and the inclusion of nitric oxide in the breathing mixture as a respiratory vasodilator. The incidence of diaphragmatic hernias varies widelyfrom 1 in 2000 to 1 in 4000 newborns; this does not take into account a large group of stillborns with diaphragm malformations [2].