J Perinatol

. 2025 Mar 19.

 doi: 10.1038/s41372-025-02265-6. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/40108476/

Hemodynamic precision to guide surgical timing for neonates with congenital diaphragmatic hernia: a narrative review

John T Wren Jr ¹, Neil Patel ², Matthew T Harting ³, Patrick J McNamara ⁴

Affiliations Expand

• PMID: 40108476
• DOI: 10.1038/s41372-025-02265-6

Abstract

Despite a near universal approach focused on physiologic stabilization prior to surgical repair of congenital diaphragmatic hernia (CDH), a condition with significant morbidity and mortality, there remains a lack of consensus, or even guidance, on the appropriate timing for diaphragmatic reconstruction. Hemodynamic-directed care has increasingly been incorporated into the post-natal, peri-operative care of CDH, including assessments of pulmonary hypertension and ventricular dysfunction. Herein, we discuss the integration of targeted neonatal echocardiography and hemodynamic-based assessments to guide precision-directed care and inform selection of the optimal surgical repair window in this complex, heterogeneous patient population.

© 2025. The Author(s), under exclusive licence to Springer Nature America, Inc.