ABSTRACT
Evaluation of the survival rate in neonate with congenital diaphragmatic hernia [CDH] treated with gentle ventilation, very delayed surgical repair and selective use of surfactant therapy in absence of extra corporeal life support devices. A prospective study of twenty three neonates admitted to lbn Sina Hospital for surgical correction of congenital diaphragmatic hernia between July 1996 to October 1998. These babies were stabilized before transfer pre-operatively at their respective neonatal units under guidelines using gentle ventilation permitting hypercapnia, surfactant therapy and a very delayed surgical correction. Fourteen male and nine female newborns with CDH presented in the first few hours of life, their mean birth weight is 2.850kg [range 2.050-4.300kg]. Twenty patients survived a period of pre-operative medical stabilization ranged between 3-10 days [mean +/- 4.08 days]. Post operative duration of mechanical ventilation ranged between 1-27 days [mean +/- 6.5 days]. Seventeen patients survived i.e. survival rate of 74%. These data demonstrate a significant good survival rate of early presenting CDH neonates with gentle ventilation and very delayed surgical repair