Routine Intubation in Newborns With Congenital Diaphragmatic Hernia

* Abbreviations: CDH — : congenital diaphragmatic hernia IQR — : interquartile range O/E LHR — : observed-to-expected lung-to-head ratio PH — : pulmonary hypertension SBA — : spontaneous breathing approach Congenital diaphragmatic hernia (CDH) is a rare developmental defect of the diaphragm and lungs, resulting in pulmonary hypoplasia and pulmonary hypertension (PH). With improved prenatal diagnostics, lung hypoplasia severity in CDH can be classified more accurately.1,2 Infants with isolated left-sided CDH, observed-to-expected lung-to-head ratio (O/E LHR) ≥50%, and intraabdominal liver position are categorized as “mild lung hypoplasia” because their survival rate exceeds 95%.1,3 All international guidelines advise routine intubation at birth for neonates with CDH to establish adequate oxygenation and cardiovascular stability.4–7 … Address correspondence to Suzan C.M. Cochius-den Otter, MD, Erasmus University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, Netherlands. E-mail: s.denotter{at}erasmusmc.nl