Your browser doesn't support javascript.
loading
Congenital diaphragmatic hernia.
Indian J Pediatr ; 2000 Sep; 67(9): 665-70
Artigo em Inglês | IMSEAR | ID: sea-79256
ABSTRACT
Over the last two decades there has been a constant improvement in the understanding of the pathophysiology of Congenital Diaphragmatic Hernia (CDH) and its management. However, the ideal treatment remains elusive. The earlier management strategy of immediate surgery is replaced by the principle of physiological stabilisation and delayed surgery. Conventional mechanical ventilatory techniques, with high pressures and hyperventilation to reverse ductal shunting and cause alkalinization, are being questioned because of the risks of barotrauma and consequent broncho-pulmonary dysplasia. It has also been shown that paralysis with pancuronium bromide for patients on conventional mechanical ventilation results in increased incidence of sensorineural hearing loss in childhood survivors of CDH. With the introduction of the concept of permissive hypercapnia and high frequency oscillation ventilation, the complications of pulmonary barotrauma are circumvented. Although ECMO therapy is invasive, yet has improved survival by about 15% independently, especially in critically ill infants who have the predictive mortality rate of more than 80%. Further insights into the pathophysiology of CDH and the introduction of less invasive therapeutic techniques in the form of high frequency oscillation ventilation, inhalation nitric oxide, surfactant, and perfluorocarbon liquid ventilation may even make the need for ECMO redundant.
Assuntos
Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Diagnóstico Pré-Natal / Prognóstico / Cuidados Pré-Operatórios / Humanos / Recém-Nascido / Ventilação de Alta Frequência / Oxigenação por Membrana Extracorpórea / Análise de Sobrevida / Fatores de Risco / Hérnia Diafragmática Tipo de estudo: Estudo diagnóstico / Estudo de etiologia / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Indian J Pediatr Ano de publicação: 2000 Tipo de documento: Artigo

Similares

MEDLINE

...
LILACS

LIS

Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Diagnóstico Pré-Natal / Prognóstico / Cuidados Pré-Operatórios / Humanos / Recém-Nascido / Ventilação de Alta Frequência / Oxigenação por Membrana Extracorpórea / Análise de Sobrevida / Fatores de Risco / Hérnia Diafragmática Tipo de estudo: Estudo diagnóstico / Estudo de etiologia / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Indian J Pediatr Ano de publicação: 2000 Tipo de documento: Artigo