Congenital diaphragmatic hernia secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Secondary prevention occurs once the disease has developed and aims to prevent progression and development of further complications. CDH related complications include tracheobronchomalacia, pneumothorax, pulmonary hypertension, pulmonary infections and respiratory failure. Early screening may assist in complication prevention. Genetic counselling should be offered to all affected families as well as the importance of regular follow up.^[1]

Secondary Prevention

Secondary Prevention
Complication	Preventative Methods
Pulmonary Hypertension,	High-frequency ventilation and gentle ventilation; these help to reduce the barotrauma^[2] Improvement of condition with nitric oxide and prostaglandin-E1
Pneumothorax	All surgical procedures that can rupture pleura such as transbronchial and transthoracic interventions should be performed under ultrasound guidance
Respiratory failure/ Pulmonary infections^[3]	Control of primary illness Administration of influenza and pneumococcal vaccinations
Gastroesophageal reflux^[4]^[5]	Frequent and small meals Avoid laying down for 3 hours after a meal Head end of the bed elevated
kidney stones^[6]^[7]	Diet low in salt Diet high in calcium and magnesium Increased fluid intake

References

↑ “StatPearls”. ( ). 2022: . PMID 32310536 Check |pmid= value (help).
↑ Okuyama H (2007). “[Current and future strategy in the treatment of congenital diaphragmatic hernia]”. Nihon Geka Gakkai Zasshi. 108 (6): 325–8. PMID 18051475.
↑ Sweet DD, Naismith A, Keenan SP, Sinuff T, Dodek PM (March 2008). “Missed opportunities for noninvasive positive pressure ventilation: a utilization review”. J Crit Care. 23 (1): 111–7. doi:10.1016/j.jcrc.2007.04.002. PMID 18359428.
↑ “StatPearls”. ( ). 2022: . PMID 32310536 Check |pmid= value (help).
↑ DeVault KR, Castell DO, American College of Gastroenterology (2005). “Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease”. Am J Gastroenterol. 100 (1): 190–200. doi:10.1111/j.1572-0241.2005.41217.x. PMID 15654800.
↑ Lund DP, Mitchell J, Kharasch V, Quigley S, Kuehn M, Wilson JM (1994). “Congenital diaphragmatic hernia: the hidden morbidity”. J Pediatr Surg. 29 (2): 258–62, discussion 262-4. doi:10.1016/0022-3468(94)90329-8. PMID 8176602.
↑ Assadi F, Moghtaderi M (2017). “Preventive Kidney Stones: Continue Medical Education”. Int J Prev Med. 8: 67. doi:10.4103/ijpvm.IJPVM_17_17. PMC 5609393. PMID 28966756.

Overview