Fernando Bullettin
14 statements · 1 topic
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In Europe, some maternal-fetal medicine centers perform FETO but then transfer patients to separate centers for delivery and neonatal care, creating a separation between fetal intervention and postnatal ECMO expertise.
clinical ·
Congenital Diaphragmatic Hernia
Prolonged operative time required for thoracoscopic CDH repair in babies requiring inotropic support or special ventilation (with increased CO2 and decreased pH) is detrimental to the patient.
opinion ·
Congenital Diaphragmatic Hernia
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Fernando's statements about Congenital Diaphragmatic Hernia 14 statements
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Case-Based Journal Review: Congenital Diaphragmatic Hernia 2023
Quotation
I am not agree with that since you review the number of the center with a great number of babies with CDH that are doing ECMO, the survival of this patient is almost 50 or more%.
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Statement
Centers with high CDH volume performing ECMO achieve survival rates of approximately 50% or more in severe CDH patients.
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Statement
In Europe, some maternal-fetal medicine centers perform FETO but then transfer patients to separate centers for delivery and neonatal care, creating a separation between fetal intervention and postnatal ECMO expertise.
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Statement
One Chilean center's protocol involves ECMO cannulation at 6-8 hours of life followed by CDH repair 8-10 hours after cannulation.
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At least four published reports confirm the data showing benefit of early repair on ECMO, representing a practice change in the field.
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Quotation
I think sometimes after a big study, many centers change their practice, and there's been, I think, at least 4 of these reports that confirm this data, and my feeling is that this is a practice change.
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Statement
Prolonged operative time required for thoracoscopic CDH repair in babies requiring inotropic support or special ventilation (with increased CO2 and decreased pH) is detrimental to the patient.
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Statement
The 80% chest wall deformity rate with synthetic patches may be inflated by inclusion of skeletal deformities inherent to CDH disease rather than caused by the patch itself.
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Quotation
One of the problems is the skeletal deformity that is coming with the disease. So I don't know if it's the pen of the patch.
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I'm doing the fund obligation in those patients that are type D defect and are on ECMO.
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Statement
One surgeon performs fundoplication at initial CDH repair selectively in patients with type D defects who are on ECMO.
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Quotation
I got the result different what what the studies say in those babies that I have done the fund duplication. I haven't done another surgery for that. So, it's been a definitive repair both from the CDH and the fund obligation.
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Statement
In one surgeon's experience with selective fundoplication in type D ECMO patients, none have required subsequent fundoplication surgery, representing definitive repair of both CDH and reflux.
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