CPAP in CDH in a Newborn: Why Not?

Why is Positive Pressure Ventilation contraindicated in babies having Congenital Diaphragmatic hernia?

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Because of the risk of worsening of their condition.

  1. Air can enter the herniated organs.
  2. Excerbation of pulmonary hypoplasia.
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Risk of herniation in viral organs

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It can cause herniation of abdominal contents into the chest cavity.

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Because it can force air into the intestines that have herniated into the chest

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Positive Pressure Ventilation in CDH babies can push air into their belly, further squishing delicate lungs and worsening the hernia.

Air can worsen the herniation causing respiratory insufficiency, mediastinal shift.

Risk of herniation

It can insufflate the herniated abdominal contents in the thorax, worsening lung compression and respiratory distress, leading to decreased oxygenation.

It will cause respiratory compromise by fill the intrathoracic viscera with air and that increases lung compression