congenital diaphragmatic hernia (cdh) · delivery planning. care after birth. breathing tube....

Congenital Diaphragmatic Hernia (CDH)Prenatal

Background

Anatomy

What happens with diaphragmatic hernia?

Abdominal organs move into the chest, preventing the lungs from growing

Diaphragmatic hernia anatomy

What can you expect now?

PictureHere

(rounded corners optional)

Prenatal ultrasounds

Delivery Planning

Care after birth

Breathing tube

Transfer to Seattle Children’s

Supportive care in the Newborn Intensive Care Unit - NICU

standard ventilators jet ventilators inhaled nitric oxide

© Drager. All rights reserved.

ECMO (Extra Corporeal Membrane Oxygenation)

ECMO (Extra Corporeal Membrane Oxygenation)

Surgery

Repair of diaphragmatic hernia

Intestine and/or organs are pulled back down into the abdomen

Repair of diaphragmatic hernia

Hole in diaphragm

Repaired diaphragm

X-rays before & after surgery

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

What about eating?

• GERD

• Feeding advancement and therapy

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

Discharge home

When can the baby go home?

• Criteria for discharge

• Typical care and supplies at discharge

• Variable length of hospital stay

Care after discharge

Surgery - Pulmonary Follow-up Clinic

Dr. Thida Ong

After Surgery

• Lung growth and function

• Intestinal obstruction

• Hernia recurrence

Outcomes

• 80-90% survival for CDH at Seattle Children’s

• Lower survival (50%) for babies who need ECMO

9/19PE2782

Questions?