Ventilator strategies in congenital diaphragmatic hernia

In brief

This article reviews evidence-based ventilator management strategies for newborns with congenital diaphragmatic hernia (CDH), a condition characterized by pulmonary hypoplasia and persistent pulmonary hypertension. It addresses lung-protective ventilation approaches, optimal ventilator modes, and strategies to minimize ventilator-induced lung injury while supporting gas exchange in this complex patient population.

• Gentle ventilation strategies prioritize lung protection over normalization of blood gases in CDH management
• Permissive hypercapnia and accepting preductal saturations 85-95% reduces ventilator-induced lung injury
• High-frequency oscillatory ventilation may benefit patients failing conventional ventilation
• Avoid hyperventilation and excessive oxygen exposure which can worsen pulmonary hypertension
• Individualized ventilator management based on pulmonary hypoplasia severity improves outcomes

Written by the GCMD Library team from the article.