OBJECTIVE: To describe the clinical evolution of newborns with congenital diaphragmatic hernia admitted to neoretal Intensive Care Unit of a tertiary private hospital and treated with a gentle ventilatory approach. METHODS: Analysis of charts of patients born between June 2001 and July 2006. The following data were collected: birth weight, gestational age, sex, delivery room procedures, pre and post-surgery parameters and survival rate. RESULTS: Eight newborns with diagnosis of congenital diaphragmatic hernia were included. They presented birth weight from 2.38 to 3.45kg, gestational age between 36 and 39 weeks; five of them were males. All infants were intubated at delivery within the first minute of life. The surgery was performed between the 2nd and the 6th days of life, and a patch was needed in four patients. A "gentle" ventilation strategy was used in six infants, targeting normal pre-ductal PaO2 and allowing hypercapnia (PaCO2 between 50 and 60mmHg). The extubation occurred between the 1st and 12th day after surgery, except for one infant who died. Six newborns were discharged with an average post-natal age of 30 days (19 to 55 days). The survival rate was 75%. CONCLUSIONS: The systematic care of infants with diagnosis of congenital diaphragmatic hernia can assure a survival rate comparable to reference centers.
hernia, diaphragmatic; respiration, artificial; infant, newborn
