Congenital Diaphragmatic Hernia (CDH) Services
Children's has a national reputation for providing the most advanced care available for babies with congenital diaphragmatic hernias. Our multidisciplinary team of physicians, registered nurses, nurse practitioners, respiratory therapists, dietitians, chaplains, and social workers has cared for more than 275 CDH patients. Our survival rates meet and in some cases exceed national statistics.
CDH services are provided at Children's - Minneapolis and include:
- Gentle ventilation strategies, including high-frequency ventilation. Neonatal critical care uses gentle ventilation strategies, including high-frequency ventilation, to protect fragile underdeveloped lungs.
- Surgical delays where possible and appropriate. A delay in corrective surgery may be possible to allow sick newborns to recover from the stress of delivery before facing the stress of surgery.
- Pediatric surgical expertise in repairing CDH.
- Inhaled nitric oxide. Recent studies indicate that babies who are on ventilators and are receiving nitric oxide may have a smaller risk of serious breathing and other health complications.
- ECMO (Extra-Corporeal Membrane Oxygenation), a heart-lung bypass procedure to support the most profoundly ill children.
- Neurodevelopmental services including a follow-up clinic, discharge planners and, if necessary, home care services.
- On-site lactation consultants.
- Child life specialists to help siblings understand and cope with the CDH diagnosis. Child life specialists staff the sibling play area, which provides siblings with a place to play during hospital visits.
- Family Resource Center, including a library, wireless Internet access and assistance with building a CaringBridge™ Web site to help stay connected with family and friends while in the hospital.
What to expect at Children's
Children's offers prenatal counseling for families anticipating the birth of a baby with CDH. Based on scientific data and knowledge gained from your prenatal evaluations, a neonatologist will discuss your baby's anticipated medical needs with you. Accurate and detailed counseling is provided to enable you to make informed decisions about your child's care. You will tour the neonatal intensive care unit (NICU) and receive educational materials about the care of babies with CDH as well as information about ECMO (Extra-Corporeal Membrane Oxygenation). Experienced perinatologists will care for you during the remainder of your pregnancy.
Your baby's birth
Parents who wish to give their baby access to the full range of Children's CDH services give birth in Minneapolis at Abbott-Northwestern Hospital, which is connected to Children's – Minneapolis. Babies with CDH often are very ill from the moment their umbilical cord is clamped and they become dependent on their own lungs and pulmonary blood vessels. A Children's neonatal physician and neonatal transport team, who are experienced in the immediate resuscitation and stabilization of critically ill babies, attend all CDH births at Abbott-Northwestern.
Post-delivery care for your baby
From the delivery room, your child will be taken to Children's neonatal intensive care unit (NICU) to receive 24-hour care from an in-house neonatal physician and our multidisciplinary team. Pediatric surgeons, with a combined experience of more than 125 years, also will care for your child. Together with the neonatologist they will determine the timing of surgery to repair the diaphragmatic defect.
Making care decisions for your family
Parents of a child with a CDH diagnosis may be faced with difficult decisions at many points in time—before, during, and after delivery. Unfortunately, there is no proven and universally accepted method of determining the amount of support your baby will require after birth. Interpreting information you find while researching this problem can be difficult as well. It is best to discuss your research and the specifics of your case with a physician who regularly treats babies with CDH.