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Abstract：
In 2010, the congenital diaphragmatic hernia (CDH) EURO Consortium published a standardized neonatal treatment protocol. Five years later, the number of participating centers has been raised from 13 to 22. In this article the relevant literature is updated, and consensus has been reached between the members of the CDH EURO Consortium. Key updated recommendations are: (1) planned delivery after a gestational age of 39 weeks in a high-volume tertiary center; (2) neuromuscular blocking agents to be avoided during initial treatment in the delivery room; (3) adapt treatment to reach a preductal saturation of between 80 and 95% and postductal saturation >70%; (4) target PaCO2 to be between 50 and 70 mm Hg; (5) conventional mechanical ventilation to be the optimal initial ventilation strategy, and (6) intravenous sildenafil to be considered in CDH patients with severe pulmonary hypertension. This article represents the current opinion of all consortium members in Europe for the optimal neonatal treatment of CDH.
摘要：
2010年，先天性膈疝（CDH）欧洲联盟发布了标准化的新生儿治疗方案。五年后,参与中心的数量从13个增加到22个。本文对相关文献进行了更新,CDHEURO财团成员之间已达成共识。更新后的主要建议是：（1）在大批量三级中心的胎龄为39周后计划分娩；（2）在产房初始治疗期间应避免使用神经肌肉阻滞剂；（3）适应治疗以达到80％至95％之间的导管前饱和度和导管后饱和度>70％；（4）目标PaCO2在50至70mmHg之间；（5）常规机械通气是最佳的初始通气策略，（6）在CDH重度肺动脉高压患者中考虑静脉注射西地那非。本文代表了欧洲所有财团成员对CDH的最佳新生儿治疗的当前观点。
