[Intensive care and anesthesia maintenance in neonatal infants with congenital diaphragmatic hernia].

The authors pool their experience gained with intensive care in 27 neonatal infants with congenital diaphragmatic hernias (CDH) in 1975 to 2006. Group 1 consisted of 13 infants admitted in 1975 to 1992; Group 2 included 14 infants admitted in 1993 to 2006; All Group 1 neonates were operated on within 6-18 hours after birth; eight children died (61.5% mortality). Group 2 neonates were operated on in different periods. Six of the 14 infants were operated on for emergency indications within the first hours after death (3 died); 6 of the 14 neonates were operated on days 4-6 after birth (1 baby died). In Group 2 neonatal infants, mortality was 28.5%, i.e. decreased by 21 times. In neonates with CDH, the complex of pre- and postoperative intensive care included artificial ventilation with currently available neonatal respirators, persistent gastric aspiration, adequate infusion therapy, antibacterial therapy, intraoperative and postoperative analgesia, parenteral and tube feeding, inotropic support, and, if indicated, surfactant.