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