Research: Neonatal intensive care unit on-site surgery for congenital diaphragmatic hernia

Exp Ther Med

. 2022 Jun;23(6):436. doi: 10.3892/etm.2022.11363. Epub 2022 May 10.

Neonatal intensive care unit on-site surgery for congenital diaphragmatic hernia

Alina Elena Gaiduchevici 1Cătălin Gabriel Cîrstoveanu 1 2Bogdan Socea 3 4Ana Michaela Bizubac 1Carmen Mariana Herișeanu 1Cristina Filip 5Florin Dumitru Mihălțan 6 7Mihai Dimitriu 8 9Florentina Jacotă-Alexe 8Mihail Ceaușu 10 11Radu-Iulian Spătaru 12 13Affiliations expand

Free PMC article


The present study presents the experience gained in the Newborn Intensive Care Unit (NICU) of ‘Maria S. Curie’ Emergency Clinical Hospital for Children in Bucharest (Romania) after performing a series of bedside surgery interventions on newborns with congenital diaphragmatic hernia (CDH). We conducted a retrospective analysis of the data for all patients operated on-site between 2011 and 2020, in terms of pre- and post-operative stability, procedures performed, complications and outcomes. An analysis of a control group was used to provide a reference to the survival rate for non-operated patients. The present study is based on data from 10 cases of newborns, surgically operated on, on average, on the fifth day of life. The main reasons for operating on-site included hemodynamical instability and the need to administer inhaled nitric oxide (iNO) and high-frequency oscillatory ventilation (HFOV). There were no unforeseen events during surgery, no immediate postoperative complications and no surgery-related mortality. One noticed drawback was the unfamiliarity of the surgery team with the new operating environment. Our experience indicates that bedside surgery improves the likelihood of survival for critically ill neonates suffering from CDH. No immediate complications were associated with this practice.

Keywords: NICU infrastructure; bedside surgery; congenital diaphragmatic hernia; severe pulmonary hypertension.

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