Congenital Diaphragmatic Hernia and the Management of Persistent Foetal Circulation

Abstract

Twenty-two cases of diaphragmatic hernia, presenting from 1978 to 1982, were reviewed. Sixteen patients presented before 24 hours of life, of whom nine survived (56%). Six were late presenters who all did well. Seven babies had ten documented episodes of persistent foetal circulation (PFC) occurring as early as three hours postoperatively, although three babies had episodes in their second week. Hyperventilation, with hand bagging, was successful in treating five out of six episodes of PFC (83%), without complication. Tolazoline caused improvement in two out of four episodes of PFC but was associated with significant complications. We recommend early and sometimes persistent use of hyperventilation by hand bagging as a means of managing PFC in diaphragmatic hernia.

Bochdalek hernias associated with intrathoracic kidney: A case report and systematic review of outcomes including renal function

“…In neonates, congenital diaphragmatic hernias can be associated with considerable morbidity and mortality [4], with possible pulmonary hypoplasia [5] or persistent fetal circulation [6], relying on early surgical correction. Later presentation in adults however is usually asymptomatic and discovery typically incidental on chest radiography.…”