Standardized Postnatal Management of Infants with Congenital Diaphragmatic Hernia in Europe: The CDH EURO Consortium Consensus - 2015 Update

In 2010, the congenital diaphragmatic hernia (CDH) EURO Consortium published a standardized neonatal treatment protocol. Five years later, the number of participating centers has been raised from 13 to 22. In this article the relevant literature is updated, and consensus has been reached between the...

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Bibliographic Details
Published inNeonatology (Basel, Switzerland) Vol. 110; no. 1; pp. 66 - 74
Main Authors Snoek, Kitty G., Reiss, Irwin K.M., Greenough, Anne, Capolupo, Irma, Urlesberger, Berndt, Wessel, Lucas, Storme, Laurent, Deprest, Jan, Schaible, Thomas, van Heijst, Arno, Tibboel, Dick
Format Journal Article
LanguageEnglish
Published Basel, Switzerland 01.01.2016
Subjects
Clinical Protocols - standards
Consensus
Consensus Statement
Europe
Expert Testimony
Hernias, Diaphragmatic, Congenital - complications
Hernias, Diaphragmatic, Congenital - therapy
Humans
Hypertension, Pulmonary - therapy
Infant
Infant, Newborn
Monitoring, Physiologic
Postnatal Care - standards
Practice Guidelines as Topic
Respiration, Artificial
Sildenafil Citrate - therapeutic use
Congenital diaphragmatic hernia
Standardized treatment
Consensus
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Summary:In 2010, the congenital diaphragmatic hernia (CDH) EURO Consortium published a standardized neonatal treatment protocol. Five years later, the number of participating centers has been raised from 13 to 22. In this article the relevant literature is updated, and consensus has been reached between the members of the CDH EURO Consortium. Key updated recommendations are: (1) planned delivery after a gestational age of 39 weeks in a high-volume tertiary center; (2) neuromuscular blocking agents to be avoided during initial treatment in the delivery room; (3) adapt treatment to reach a preductal saturation of between 80 and 95% and postductal saturation >70%; (4) target PaCO 2 to be between 50 and 70 mm Hg; (5) conventional mechanical ventilation to be the optimal initial ventilation strategy, and (6) intravenous sildenafil to be considered in CDH patients with severe pulmonary hypertension. This article represents the current opinion of all consortium members in Europe for the optimal neonatal treatment of CDH.
ISSN:1661-7800
1661-7819
DOI:10.1159/000444210