Semin Fetal Neonatal Med
. 2025 Jul 15:101655.
doi: 10.1016/j.siny.2025.101655. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/40701860/
In search of “optimal care”: where should congenital diaphragmatic hernia be managed?
Jessica C Pollack 1, Tim Jancelewicz 2, Yigit S Guner 3
Affiliations Expand
- PMID: 40701860
- DOI: 10.1016/j.siny.2025.101655
Abstract
Management of congenital diaphragmatic hernia (CDH) varies widely between institutions, and emerging data suggest that these center-specific practices influence patient outcomes. Given the resource-intensive nature of extracorporeal life support (ECLS) and its reliance on multidisciplinary expertise, regional and hospital level factors are likely critical in optimizing outcomes for this high-risk population. This review synthesizes the existing literature on institutional factors contributing to observed differences in outcomes across centers, explores the complexity of center-level variation in CDH management, and describes targeted research and quality improvement initiatives aimed at enhancing outcomes for neonates affected by this condition.
Keywords: Center effect; Congenital diaphragmatic hernia (CDH); ECMO; Fetal endoscopic tracheal occlusion (FETO); Volume-outcome relationship.
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