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Research: Extremely low birth weight infant surviving left congenital diaphragmatic hernia: a case report

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Research: Extremely low birth weight infant surviving left congenital diaphragmatic hernia: a case report

Transl Pediatr

. 2021 Nov;10(11):3091-3095. doi: 10.21037/tp-21-355. https://pubmed.ncbi.nlm.nih.gov/34976775/

Extremely low birth weight infant surviving left congenital diaphragmatic hernia: a case report

Seongjin Choi 1Euiseok Jung 1Jung-Man Namgoong 2Jiyoon Jeong 1Taehyen Cha 1Byong Sop Lee 1Ellen Ai-Rhan Kim 1Ki-Soo Kim 1Affiliations expand

Free PMC article

Abstract

In this study, we present the case of a 900 g, male infant born at 27+5 weeks, who was placed on high frequency oscillatory ventilation (HFOV) until repair of a left congenital diaphragmatic hernia (CDH) at 39 days of life (DOL). To date, this is the smallest infant with repair of the left CDH reported in the literature. After birth, he passed the cardiopulmonary stabilization phase and successfully underwent delayed surgery; in the process, he received ventilator assistance through HFOV. He weighed 1,660 gm at the time of surgery. We performed the thoracoscopic primary closure of the diaphragmatic defect. He was extubated on post-operation day (POD) 7 and discharged from hospital on POD 36 with 0.1 L/min supplemental oxygen via nasal cannula. He is being followed for growth and development and there has been no recurrence at the surgical site at 24 months of corrected age. In this case, high mean airway pressure (MAP) was required based on the patient’s weight to achieve adequate recruitment of the left lung, and the patient was diagnosed with mental developmental delay on Bayley Scales of Infant Development-II. Thus, we suggest that the postnatal course and long-term outcomes for extremely low birth weight (ELBW) and preterm infants with left CDH is different from that for full-term babies. Therefore, future research should focus on preterm infants with left CDH.

Keywords: Congenital diaphragmatic hernias (CDH); case report; extremely low birth weight (ELBW); survival.

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