Clinical Case Database / Category: Patient Management

Congenital diaphragmatic hernia - a neonatal challenge

Publication details

Dr Donna Nicholls, Jonathan Cusack
Foundation Years Journal, volume 8, issue 8, p.16 (123Doc Education, London, September 2014)


Congenital diaphragmatic hernia (CDH) is a developmental defect of the diaphragm in which the abdominal contents enter the thoracic cavity. Optimal early management of the patient is critical to prevent complications. As multicentre randomised controlled trials in CDH are lacking, a consensus statement, issued by the CDH EURO Consortium, was produced with the hope of standardising management of CDH in European countries (1).

Baby LM had an antenatal diagnosis of a large congenital diaphragmatic hernia. We present the initial days of her life with the challenges she faced, discussing the important management points.

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Dr Donna Nicholls (Corresponding author)

Neonatal Registrar
University Hospitals Of Leicester
Level 5 - Kensington Building
Leicester Royal Infirmary, Leicester, LE1 5WW

Jonathan Cusack

Neonatal Consultant
University Hospitals Of Leicester
Level 5 - Kensington Building
Leicester Royal Infirmary, Leicester, LE1 5WW


1.  Reiss I, Schaible T, van den Hout et al. Standardized Postnatal Management of Infants with Congenital Diaphragmatic Hernia in Europe: The CDH EURO Consortium Consensus. Neonatology 2010;98:354-364.

2.  de Buys Roessingh AS, Dinh-Xuan AT. Congenital diaphragmatic hernia: current status and review of the literature. Eur J Pediatr 2009;168:393.

3.  Askie L, Ballard R, Cutter G et al. Inhaled nitric oxide in preterm infants: An Individual-Patient Data Meta-Analysis of Randomized Trials. Pediatrics 2011;128:729-739.

4.  Barrington KJ, Finer N. Inhaled nitric oxide for respiratory failure in preterm infants. Cochrane Database of Systematic reviews 2010. Issue 12. Art No.: CD000509.

5.  Kumar P and COMMITTEE ON FETUS AND NEWBORN. Use of Inhaled Nitric Oxide in Preterm Infants. Pediatrics 2014;133:164-170.

6.  Critical Care Decisions in Fetal and Neonatal Medicine: ethical issues. Nuffield Council on Bioethics web version 22 June 07 (updated).pdf.

7.  Withholding or Withdrawing Life-Sustaining Treatment in Children: A Framework for Practice. Second Edition. May 2004. Royal College of Paediatrics and Child Health.

8.  UpToDate Congenital diaphragmatic hernia: Prenatal diagnosis and management. diaphragmatic hernia&selectedTitle=1~34§ionRank=1&anchor=H11#H24.


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