Q: Magazine Issue 11 Nov. 2022 2022 Q3-Q4 Research and Innovation Magazine-joomag | Page 18

FETAL CARE & NEONATOLOGY

A Therapeutic Mindset

Can aggressive intervention and a change in mindset optimize outcomes for babies born with congenital diaphragmatic hernia( CDH)?
CDH is a life-threatening birth defect affecting about one in 2,500 infants each year. Due to a highly specialized, multidisciplinary team of experts utilizing advanced antenatal imaging, extracorporeal membrane oxygenation( ECMO) in the delivery room with early therapeutic repair on ECMO, cardiac and respiratory support, the Colorado Fetal Care Center has some of the highest CDH survival rates in the country for some of the most severe cases.
CDH, diagnosed via routine
While survival rates have
birth via surgical repair, but
high-risk patients may require
prenatal ultrasound in the
improved nationally for the
about 40 % of babies born with
repair while on ECMO to
second trimester of pregnancy,
last two decades, the team at
CDH require ECMO support as
prevent cases of non-repair
is a defect in the diaphragm
Children’ s Hospital Colorado is
a rescue therapy to maintain
and provide more time for
allowing abdominal organs
pushing survival rates of 85 %
cardiac and pulmonary
lung growth.
( e. g., intestines, stomach, liver) to herniate into the chest, compressing the intra-thoracic structures and preventing the heart and lungs from developing normally.
and beyond.
SURGICAL TIMING
Diaphragmatic hernias are typically treated soon after
function while the heart and lungs grow stronger. While surgical repair after ECMO is preferred to reduce blood product usage with lower transfusion requirements,
IMPROVING SURVIVAL FOR SEVERE CDH
When compared to repair after
( off) ECMO, repair on ECMO is
10 | CHILDREN’ S HOSPITAL COLORADO