TY - JOUR
T1 - International Survey on the Management of Congenital Diaphragmatic Hernia
AU - Zani, Augusto
AU - Eaton, Simon
AU - Puri, Prem
AU - Rintala, Risto
AU - Lukac, Marija
AU - Bagolan, Pietro
AU - Kuebler, Joachim F.
AU - Friedmacher, Florian
AU - Hoellwarth, Michael E.
AU - Wijnen, Rene
AU - Tovar, Juan A.
AU - Pierro, Agostino
PY - 2015/10/14
Y1 - 2015/10/14
N2 - 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.
AB - 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.
KW - malrotation
KW - muscle flap
KW - patch
KW - Permacol
KW - thoracoscopy
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U2 - 10.1055/s-0035-1564713
DO - 10.1055/s-0035-1564713
M3 - Article
AN - SCOPUS:84955641539
VL - 26
SP - 38
EP - 46
JO - European Journal of Pediatric Surgery
JF - European Journal of Pediatric Surgery
SN - 0939-7248
IS - 1
ER -