congenital diaphragmatic hernia (cdh) · delivery planning. care after birth. breathing tube....
TRANSCRIPT
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Congenital Diaphragmatic Hernia (CDH)Prenatal
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Background
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Anatomy
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What happens with diaphragmatic hernia?
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Abdominal organs move into the chest, preventing the lungs from growing
Diaphragmatic hernia anatomy
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What can you expect now?
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Prenatal ultrasounds
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Delivery Planning
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Care after birth
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Breathing tube
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Transfer to Seattle Children’s
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Supportive care in the Newborn Intensive Care Unit - NICU
standard ventilators jet ventilators inhaled nitric oxide
© Drager. All rights reserved.
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ECMO (Extra Corporeal Membrane Oxygenation)
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ECMO (Extra Corporeal Membrane Oxygenation)
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Surgery
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Repair of diaphragmatic hernia
Intestine and/or organs are pulled back down into the abdomen
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Repair of diaphragmatic hernia
Hole in diaphragm
Repaired diaphragm
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X-rays before & after surgery
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What to expect after surgery
• Gradually wean off support of heart and lungs
• Transfer out of NICU when off the ventilator and requiring less oxygen
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What about eating?
• GERD
• Feeding advancement and therapy
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Who is on the baby’s care team?
• Board Certified pediatric surgeons• Neonatologists• Pediatric surgical fellows and residents• Nurse practitioners• Dieticians• Pharmacists• Pediatric heart and lung specialists
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Discharge home
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When can the baby go home?
• Criteria for discharge
• Typical care and supplies at discharge
• Variable length of hospital stay
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Care after discharge
Surgery - Pulmonary Follow-up Clinic
Dr. Thida Ong
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After Surgery
• Lung growth and function
• Intestinal obstruction
• Hernia recurrence
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Outcomes
• 80-90% survival for CDH at Seattle Children’s
• Lower survival (50%) for babies who need ECMO
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Questions?