Can we improve outcome of congenital diaphragmatic hernia?

This review gives an overview of the disease spectrum of congenital diaphragmatic hernia (CDH). Etiological factors, prenatal predictors of survival, new treatment strategies and long-term morbidity are described. Early recognition of problems and improvement of treatment strategies in CDH patients may increase survival and prevent secondary morbidity. Multidisciplinary healthcare is necessary to improve healthcare for CDH patients. Absence of international therapy guidelines, lack of evidence of many therapeutic modalities and the relative low number of CDH patients calls for cooperation between centers with an expertise in the treatment of CDH patients. The international CDH Euro-Consortium is an example of such a collaborative network, which enhances exchange of knowledge, future research and development of treatment protocols

Visual and fine-motor outcomes in adolescent survivors of high-risk congenital diaphragmatic hernia who did not receive extracorporeal membrane oxygenation

OBJECTIVE: Although survivors of congenital diaphragmatic hernia (CDH) are at high risk for brain injury, little is known about their neurodevelopment. Studies exploring short-term outcomes in children who received extracorporeal membrane oxygenation (ECMO) therapy suggest an increased risk for abnormalities in tone and/or motor development. This study provides the first detailed examination of visual and fine-motor outcomes in adolescent survivors of high-risk CDH (manifesting within the first 24 h) who did not receive ECMO. STUDY DESIGN: A total of 13 CDH survivors (mean age 12.9 years) and 11 typically developing controls, matched to the CDH sample in terms of age at test, intelligence quotient and socioeconomic status (SES), completed a battery of visual and motor tests. RESULTS: CDH survivors performed normally on motor-free tests of visual-perceptual function and on tests requiring visual discrimination and scanning, but were impaired on tests requiring visual-motor integration and oral-motor programming. CONCLUSION: Survivors of high-risk CDH who did not receive ECMO treatment are at risk for long-term problems with oral motor and visuomotor control