Improved Management of Neonates With Congenital Diaphragmatic Hernias

Abstract

Intensive preoperative resuscitation for newborn infants with severe respiratory distress due to congenital diaphragmatic hernias includes (1) assisted ventilation through an endotracheal tube, (2) nasogastric suction, (3) warming of the infant, and (4) insertion of a central venous line for blood sampling and fluid administration. The response to this management is closely followed by the mixed venous blood pH and gas tensions as well as by the vital signs. The mortality in 14 babies so managed was 28% as compared to a mortality of 76% for 21 infants in whom emergency operations without preliminary resuscitation were performed.