Kongenitalna diafragmalna hernija (CDH)

Abstract

Congenital diaphragmatic hernia (CDH) is inbred anomaly which is understood as inbred flaw of diaphragm followed by herniation of abdominal viscera into chest cavity and different level of lung hypoplasia. Incidence of it is 1: 5000 of live births and it makes 8% of all massive congenital anomalies. Originally, it was considered as primarily surgical problem but in past two decades, clarification of patophysiological importance of lung hypoplasia, progressive lung hypertension as well as persistent fetal circulation in CDH, previous doctrinaire approach for urgent operational care was rejected. Primary treatment of CDH is stabilization of of neonate and fighting progressive lung hypertension in neonate. “Gentle ventilation” principle with accurate values of parameters, high frequency oscillating ventilation (HFVO) and extracorporeal membrane oxygenation (ECMO) increases survival rate up to 80%. Nowadays, surgical procedure is performed on stabile neonate as semielective procedure.