How to manage CDH??// survival?// Outcomes?!!
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- čas přidán 28. 08. 2024
- In PART II of CDH- we discuss prenatal/ delivery room/ postnatal management of Congenital Diaphragmatic Hernias. Understand the role of FIXED and REVERSIBLE pulmonary HTN. Can we do anything BEFORE the infant is born? How do we protect the lungs? What ventilator to use? Is iNO helpful? What about ECMO? When is surgery done? What is the survival? Do infants with CDH have any long-lasting issues? Review all these topics!!!
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Chandrasekharan PK, Rawat M, Madappa R, Rothstein DH, Lakshminrusimha S. Congenital Diaphragmatic hernia - a review. Matern Health Neonatol Perinatol. 2017 Mar 11;3:6. doi: 10.1186/s40748-017-0045-1. PMID: 28331629; PMCID: PMC5356475.
Horn-Oudshoorn EJJ, Knol R, Te Pas AB, et al Perinatal stabilisation of infants born with congenital diaphragmatic hernia: a review of current concepts Archives of Disease in Childhood - Fetal and Neonatal Edition 2020;105:449-454.
Has Survival Improved for Congenital Diaphragmatic Hernia? A 25-Year Review of over 5000 Patients from the CDH Study Group
Vikas S. Gupta, MD; Matthew T. Harting, MD, MS; Pamela A. Lally, MD; Charles C. Miller, PhD; Ronald B. Hirschl, MD; Carl F. Davis, FRCS; M. Sidney Dassinger, MD; Terry L. Buchmiller, MD; Krisa P. Van Meurs, MD; Bradley A. Yoder, MD; Michael J. Stewart, MBBS, FRACP; Kevin P. Lally, MD, MS, FAAP
Pediatrics (2021) 147 (3_MeetingAbstract): 939-940.
doi.org/10.154...
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**TIMESTAMPS**
01:24 Management of CDH
02:22 FETO / tracheal plugging
04:28 CDH and pulmonary HTN
05:02 Fixed hypertension
06:38 Reversible hypertension
07:55 Support the baby / NRP guidelines
09:53 Management in NICU
10:46 Choosing a ventilator
11:50 Medication options / ECHO
16:30 ECMO
18:30 Surgical repair
20:14 Outcomes of CDH
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.
I watched the whole video from the first second to the last second and I took very important notes in my notebook.
Thanks a lot for your efforts, Dr Tala! 🙏🙏 Great presentation and explanation!!!
OH WOW! That makes us so happy! Thank you so much for watching and for taking the time to write. We really appreciate you being here :)
😊
You explain everything wonderfully tala. I am Dr Sakshi, neonatology fellow from India. I keep revising from your videos 😊
Thank you so much for your comment. So glad they are helping with your education! Enjoy your fellowship!!!
I’ve been told one of my twins has this, and your videos so far have been the best I can find on the subject. I feel so much more prepared going into my assessments next week. My doctor referred me to another hospital, but all she’d say is how concerning it was and talked about an operation I can’t have - so I was in tears for days. You’ve made me feel like I understand the condition so much more and will be able to make much better decisions when we have results. Thank you! I believe only stomach is up, and hoping for the assessment to confirm. We’ll see! But thank you so much.
Congratulations on your twins. We're glad this video helped- we wish you so much luck and health with your pregnancy XX
I was very recently diagnosed with CDH. I'm 59 years old! Sharp pain on my right upper flank. Discovered by CT scan in the ER. Surgery this coming week. Faith over fear.
Oh wow that’s amazing!!! Wishing you luck and health and a quick recovery! I’ve heard of patients being diagnosed as adults but haven’t seen one! Would you consider sending us an X-ray we could use?! (Totally totally get it if not!!!). Hope all goes super smoothly!
My cdh baby boy is 16 month now, I’d never forget his time in nicu. Watching your video reminds me the time I was pregnant and life after giving birth. Happy to say he’s now a happy 1 year old boy with no complications 🎉
Oh yay! Love happy stories! Impressed you’re watching videos a year later!!! Thank you for writing to us!!!
FETO was done successfully in Toronto for my brothers grandchild in March 2024. Delivered mid May full term 8 Ibs 7 oz. We are now waiting for surgery.
Oh that’s fantastic news!!!! Congratulations- love happy stories :)
this was really good, I am from Zambia
Hello! Thanks so much for taking the time to comment!
Great video...
Thank you so much :)
Another great video!! Look forward to the video about pressors! Would you guys be interested in doing a video about SRO2 monitoring (NIRS) and what levels are expected for different conditions (standard preemie, full term, cardiac lesions, HIE)?
HI! OK this is crazy but I keep writing to manufacturers of NIRS devices so we can use their images and literally can't get anyone to answer!!!! I really want to do a video on NIRS- it is important for everyone to understand what it's testing because it sums up so much of neonatology!!! So if you have a way in- let me know!!!!
@Tala Talks NICU not sure how to reply privately but if you had a direct contact with a representative from the company would that help?
You’re right! That is exactly what I need to do!!! This stuff is all so new to us! Thank you for all you’re support :)
@Tala Talks NICU I might have a direct contact, give me a few days to track them down.
Oh wow!! Thank you so much!
Another wonderful video, like all UR videos I benefited a lot from this one
So happy! Thanks so much for watching and for subscribing :)
Great video
Thank you so much :)
Thank you so much
Nice talk.
Dr Tala, is it possible to organize a talk on "Itrauterine Growth Restriction"?
Regards
Dr TUKIJA
Than you so much Dr. Tukija for watching and for commenting. We have been planning an IUGR talk for ages!!! I promise we'll get around to it soon! Thanks for your suggestion :)
This is great thank you
Thanks so much for taking the time to comment and for subscribing :)
Hi Dr. Tala, in your next video can you go over NRP or mock code simulations in NICU?
Hello Princess Jonah! We are attempting to get clearance from NRP and then we'll go through it! Thanks so much!!
Thank you very much Dr. Tala
can I get Dr Satyan review papers ?
Hi Mohamed! Yes! It’s first reference under the video. Open access so you should be able to see it. Thanks so much!
@@TalaTalksNICU Thank you Dr Tala 🌹
From Saudi Arabia
Hello! Thanks so much for watching :)
Gonzalez Ronald White Donna Lee Steven
Ok I’ve thought really hard what this could be referring to and I can’t!!!!