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العنوان
Updates in Anesthetic Management of Congenital Diaphragmatic Hernia/
المؤلف
Abd-Elmoniem,Mohamed Ghareab
هيئة الاعداد
باحث / محمد غريب عبد المنعم
مشرف / هانى محمد الذهبى
مشرف / أيمن أحمد عبد اللطيف
مشرف / أمين محمد الأنصارى
تاريخ النشر
2016.
عدد الصفحات
84.p;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
التخدير و علاج الألم
تاريخ الإجازة
1/9/2016
مكان الإجازة
جامعة عين شمس - كلية الطب - Anesthesia
الفهرس
Only 14 pages are availabe for public view

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Abstract

Stabilization of cardiorespiratory system. Endotracheal intubation is critical, nasogastric or orogastric tube placement, Permissive hypercapnia and stable hypoxemia (>80%), associated with survival of 76%. Delayed repair (24 to 72 hours) improves survival when compared with early emergent repair. Allows stabilization of the infant before surgical repair. 1/3 of patients will require ECMO. Reports of 70% survival by Bohn with early use of HFOV and ECMO for patients unable to be stabilized on reasonable ventilatory setting (pH.7.25, Peak Pressures <30 cm H2O, pre-ductal SO2 >90% with FiO2 <60%). Inhaled nitric oxide (iNO) beneficial in isolated PPHN. Careful attention to right sided heart failure increases survival by 10%.
Finally, the introduction of ECMO and HFOV, in parallel with advances in other aspects of treatment, improved the results and the top institutions reported survivals approaching 90% although, sometimes, their statistics excluded chromosomal aberrations, multiple malformations and even some patients that did not reach surgery.