Augusto Zani1, Simon Eaton2, Prem Puri3, Risto Rintala4, Marija Lukac5, Pietro Bagolan6, Joachim F Kuebler7, Florian Friedmacher8, Michael E Hoellwarth8, Rene Wijnen9, Juan A Tovar10, Agostino Pierro1. 1. Department of Paediatric Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada. 2. Department of Pediatric Surgery, University College London Institute of Child Health, London, United Kingdom. 3. Department of Paediatric Surgery, National Children's Research Centre, Dublin, Ireland. 4. Department of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki, Finland. 5. Department of Pediatric Surgery, Faculty of Medicine, Belgrade, Serbia. 6. Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome, Italy. 7. Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany. 8. Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria. 9. Department of Pediatric Surgery, Sophia Children's Hospital, ErasmusMC, Rotterdam, The Netherlands. 10. Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain.
Abstract
AIM: This study aims to define patterns in the management of congenital diaphragmatic hernia (CDH). METHODS: A total of 180 delegates (77% senior surgeons) from 44 (26 European) countries completed a survey at the 2014 European Pediatric Surgeons' Association meeting. RESULTS: Overall, 34% of the surgeons work in centers that treat < 5 cases of CDH/y, 38% work in centers that treat 5 to 10 cases/y, and 28% work in centers that treat > 10 cases/y. Overall, 62% of the surgeons work in extra corporeal membrane oxygenation (ECMO) centers and 23% in fetal surgery centers. Prenatal work up and delivery: 47% surgeons request prenatal magnetic resonance imaging, 53% offer karyotyping, 22% perform a fetal intervention, 74% monitor head-to-lung ratio, and 55% administer maternal steroids. Delivery is via cesarean section for 47% surgeons, at 36 to 38 weeks for 71% surgeons, and in a tertiary care center for 94% of the surgeons. POSTNATAL MANAGEMENT: A total of 76% surgeons report elective intubation, 65% start antibiotics preoperatively, and 45% administer surfactant. In case of refractory hypoxia, 66% surgeons consider ECMO with a variable course. Parenteral feeding is started preoperatively by 56% of the surgeons. Only 13% of the surgeons request contrast studies preoperatively to rule out malrotation. Georg Thieme Verlag KG Stuttgart · New York.
AIM: This study aims to define patterns in the management of congenital diaphragmatic hernia (CDH). METHODS: A total of 180 delegates (77% senior surgeons) from 44 (26 European) countries completed a survey at the 2014 European Pediatric Surgeons' Association meeting. RESULTS: Overall, 34% of the surgeons work in centers that treat < 5 cases of CDH/y, 38% work in centers that treat 5 to 10 cases/y, and 28% work in centers that treat > 10 cases/y. Overall, 62% of the surgeons work in extra corporeal membrane oxygenation (ECMO) centers and 23% in fetal surgery centers. Prenatal work up and delivery: 47% surgeons request prenatal magnetic resonance imaging, 53% offer karyotyping, 22% perform a fetal intervention, 74% monitor head-to-lung ratio, and 55% administer maternal steroids. Delivery is via cesarean section for 47% surgeons, at 36 to 38 weeks for 71% surgeons, and in a tertiary care center for 94% of the surgeons. POSTNATAL MANAGEMENT: A total of 76% surgeons report elective intubation, 65% start antibiotics preoperatively, and 45% administer surfactant. In case of refractory hypoxia, 66% surgeons consider ECMO with a variable course. Parenteral feeding is started preoperatively by 56% of the surgeons. Only 13% of the surgeons request contrast studies preoperatively to rule out malrotation. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Augusto Zani; Wendy K Chung; Jan Deprest; Matthew T Harting; Tim Jancelewicz; Shaun M Kunisaki; Neil Patel; Lina Antounians; Pramod S Puligandla; Richard Keijzer Journal: Nat Rev Dis Primers Date: 2022-06-01 Impact factor: 52.329
Authors: Joseph Y Ting; Julie Autmizguine; Michael S Dunn; Julie Choudhury; Julie Blackburn; Shikha Gupta-Bhatnagar; Katrin Assen; Julie Emberley; Sarah Khan; Jessica Leung; Grace J Lin; Destiny Lu-Cleary; Frances Morin; Lindsay L Richter; Isabelle Viel-Thériault; Ashley Roberts; Kyong-Soon Lee; Erik D Skarsgard; Joan Robinson; Prakesh S Shah Journal: Front Pediatr Date: 2022-07-08 Impact factor: 3.569