Elsevier

Early Human Development

Volume 83, Issue 2, February 2007, Pages 135-136
Early Human Development

Monitoring the resuscitation of congenital diaphragmatic hernia (CDH) in the delivery room (DR)

https://doi.org/10.1016/j.earlhumdev.2006.09.032Get rights and content

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Background

Gentle ventilation strategies to minimise volutrauma have improved survival in infants with CDH. Most infants are intubated in the DR but data on DR ventilation of infants with CDH is minimal [1].

Objective

To describe the DR management of antenatally diagnosed CDH.

Design/Methods

The Human Research and Ethics Committees of the Royal Women's Hospital approved studies of neonatal resuscitation. Video and physiological recordings from infants with CDH born between January 2004 and September 2005 were reviewed. Video recordings were made using a camera mounted on the resuscitator. Operators aimed to achieve minimal chest movement and oxygen saturations (SpO2) 85%. Flow integrated tidal volume (VT) was measured using a flow sensor connected to a Florian respiratory monitor

Results

In the time period there were 12 live born infants with antenatally diagnosed CDH; data from 6 infants with video and respiratory function monitoring are presented. Mean GA, BW and median 5-min Apgar were 38.6 weeks (2.1 weeks), 3105 g (622 g) and 9 (5–10), respectively. All infants gasped at birth. None received mask ventilation and all were electively intubated and ventilated using 100% oxygen. Duration of the first intubation attempt was 36 s (23–90 s) and the time to secure and confirm ETT

Conclusions

It is possible and potentially useful to monitor infants with CDH in the DR. VTs achieved were smaller than those used in other neonatal pathologies with correspondingly higher CO2 levels. Further studies are required to optimise management of these infants in the DR.

References (1)

  • D. Bohn

    Congenital diaphragmatic hernia

    Am J Respir Crit Care Med

    (2002)

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