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June 2, 2026NeoReviews0 citations

Evolving Approaches to Congenital Diaphragmatic Hernia Management

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ALAbby C. LarsonJGJason GienSDS. Chris Derderian

Key Points

  • To review current practices and advancements in the management of congenital diaphragmatic hernia (CDH).
  • Synthesized contemporary evidence on the continuum of care for CDH, including prenatal diagnosis and treatment.
  • Examined the roles of postnatal stabilization, ECMO, and surgical repair in improving survival rates.
  • Highlighted emerging areas like precision risk stratification and long-term care models.
  • Survival rates in isolated mild to moderate CDH cases now approach 75% to 90%.
  • Emerging guidelines for ECMO and surgical interventions support enhanced management strategies.
  • Long-term care models show promise in addressing chronic morbidity and optimizing survivorship.

Abstract

Congenital diaphragmatic hernia (CDH) is a complex developmental anomaly characterized by pulmonary hypoplasia, abnormal pulmonary vascular development, and variable cardiac dysfunction. Due to advances in neonatal intensive care, center expertise, and surgical repair after physiologic stability, mortality has improved over the past few decades, with survival rates in isolated mild to moderate cases approaching 75% to 90%. This review synthesizes contemporary evidence across the continuum of care for CDH: prenatal diagnosis and imaging; fetal intervention, including fetoscopic endoluminal tracheal occlusion (FETO); delivery planning; postnatal stabilization; ventilatory and hemodynamic management; extracorporeal membrane oxygenation (ECMO); surgical repair; postoperative care; chronic morbidity; and survivorship. Emerging areas include precision prenatal risk stratification, refinement of FETO, harmonized ECMO and surgical guidelines, and long-term multidisciplinary models of care.

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Cite This Study

Larson et al. (2026) studied this question.

synapsesocial.com/papers/6a1e72ad30b38c64201b5debhttps://doi.org/10.1542/neo.27-6-019
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