CONGENITAL DIAPHRAGMATIC-HERNIA - SURVIVAL TREATED WITH VERY DELAYED SURGERY, SPONTANEOUS RESPIRATION, AND NO CHEST TUBE

This report suggests that stabilization of the intrauterine to extraut erine transitional circulation combined with a respiratory care strate gy that avoids pulmonary overdistension, takes advantage of inherent b iological cardiorespiratory mechanics, and very delayed surgery for co ngenital diaphragmatic hernia results in improved survival and decreas es the need for extracorporeal membrane oxygenation (ECMO). This retro spective review of a 10 year experience in which the respiratory care strategy, ECMO availability, and technique of surgical repair remained essentially constant describes the evolution of this method of manage ment of congenital diaphragmatic hernia. Copyright (C) 1995 by W.B. Sa unders Company