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Congenital Diaphragmatic Hernia
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
The All Children's philosophy is that starting NG feeds before oral feeding capability causes babies to lose the developmental connection between oral feeding and satiety — Paul Kingma, Improving Outcomes for Congenital Diaphragmatic Hernia (CDH): Protocol Changes at Cincinnati Children's · 2:20
CDH-ECMO - VV vs. VA - Repair on ECMO: Update Course 2015
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Dr. Wulkan, Surgeon-in-Chief, Children's Healthcare of Atlanta, presents a case of a 35 week gestational aged female with respiratory distress at birth and the ECHO shows super-systemic pulmonary pressure. The case study generated debate am
video10:45 · Jan 2019
Improving Outcomes for Congenital Diaphragmatic Hernia (CDH): Protocol Changes at Cincinnati Children's
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Discover how Cincinnati Children's Hospital implemented protocol changes to significantly improve outcomes for babies with Congenital Diaphragmatic Hernia (CDH). This video details updates in ventilator management, ECMO utilization, blood p
video5:22 · Jun 2026
Technical principles for CDH repair include: use open approach for large defects, avoid biologic mesh alone, minimize tension on repair, and place adequate sutures. CDH - MIS vs. Open: Update Course 2015 · 4:10
Controversies in Congenital Diaphragmatic Hernia: Update Course 2018
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At the 6th Annual Pediatric Surgery Update Course, Dr. Mark Wulkan discusses controversies in congenital diaphragmatic hernia including advantages of open versus minimally invasive repair (with visualization of technique), timing of CDH rep
video41:42 · Sep 2018
Challenges in Diaphragmatic Hernia Repair: Update Course 2016
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Dr. Mark Wulkan discusses recurrent and complicated congenital diaphragmatic hernia repairs. Dr. Wulkan's presentation includes insight of indications of these hernias, contraindications to MIS repair, pericostal suture, SIS underlay mesh,
video44:15 · Oct 2018
CDH - MIS vs. Open: Update Course 2015
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Dr. Mark Wulkan discusses the repair ofcongenital diaphragmatic hernias by minimally invasive approach versus an open approach. Dr. Wulkan's demonstration includes complications of aminimally invasive versus an open approach to thecongenita
video5:57 · Jan 2019
CDH-ECMO Routine Patient Preoperative Workup, Timing, Technique: Update...
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Dr. Wulkan, Surgeon-in-Chief, Children's Healthcare of Atlanta,presents a routine newborn with congenital diaphragmatic hernia diseaseand discusses and debates preoperative workup, timing, and technique. Dr. Wulkan suggests ECHOto be a key
video3:31 · Jan 2019
Fetoscopic Endoluminal Tracheal Occlusion (FETO)
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Did you know that we can do surgery on a fetus? In today's episode, we hear from Dr. Foong-Yen Lim, M.D. about Fetoscopic Endoluminal Tracheal Occlusion or FETO to treat Congenital Diaphragmatic Hernia (CDH) with Host Rod Gerardo, M.D.
podcast5:54 · Jul 2021
Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
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This video, featuring Dr. Beth Rymeski from Cincinnati Children's, details the procedural aspects of Fetoscopic Endoluminal Tracheal Occlusion (FETO). It explains how a fetoscope is used to insert and inflate a balloon in the fetal trachea,
video4:30 · Jul 2026
In acute gastric volvulus with sudden onset of symptoms, initial management includes securing two good points of IV access and managing the ABCs before proceeding to imaging or surgery. — Chris Pastor, Neonatal Gastric Volvulus with Dr. Jason Frischer · 9:38
Neonatal Gastric Volvulus with Dr. Jason Frischer
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Gastric volvulus is a rare pathology for the pediatric surgical patient and when it happens, you want to be ready for potential surgical intervention. In this episode, Dr. Jason Frischer discusses the basics of diagnosis and management for
podcast11:17 · Jun 2022
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. — Fernando Bullettin, Case-Based Journal Review: Congenital Diaphragmatic Hernia 2023 · 14:23
Stay Current Journal Club: Episode 1 - Ventricular Dysfunction in CDH and...
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Introducing the Stay Current in Pediatric Surgery Journal club - run by residents across the country. In this episode, Vik Gupta and Joe L'Huillier talk about the role of ventricular dysfunction in the prognosis of congenital diaphragmatic
podcast16:50 · Feb 2021
Best of the Best in Pediatric Surgery Winner Announcement
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Kudos to all of the amazing individuals and societies who came together to create a truly unique and enlightening event, but there could only be one winner.... Congratulations to Kasra Khalaj, PhD, MSc and the Canadian Association for Pedi
video8:26 · Apr 2022
CAPS - Administration of amniotic fluid stem cell extracellular vesicles regenerates the lung epithelium in fetal rats with CDH at translationally relevant developmental stages - Kasra Khalaj
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Listen to Kasra Khalaj gave his presentation of "Administration of amniotic fluid stem cell extracellular vesicles regenerates the lung epithelium in fetal rats with CDH at translationally relevant developmental stages" at the first ever Be
video7:42 · May 2022
EUPSA - MicroRNAs in amniotic fluid stem cellextracellular vesicles modulate lung development in experimental congenital diaphragmatic hernia - Kasra Khalaj
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Listen to Kasra Khalaj gave his presentation of "MicroRNAs in amniotic fluid stem cellextracellular vesicles modulate lung development in experimental congenital diaphragmatic hernia" at the first ever Best of the Best in Pediatric Surgery
video10:03 · May 2022
EUPSA - Circular RNA profiles isolated from amniotic fluidscan distinguish between CDH survivors and non-survivers - Richard Wagner
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Listen to Richard Wagner gave his presentation of "Circular RNA profiles isolated from amniotic fluidscan distinguish between CDH survivors and non-survivers" at the first ever Best of the Best in Pediatric Surgery event.
video9:12 · May 2022
IFMSS 2019 Clinical Studies
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podcast19:13 · Nov 2022
BOB in Ped Surg 2023 - AAP Winner - Shelby Sferra, MD
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Watch the AAP winner, Shelby Sferra, MD, present her presentation on "Racial and Ethnic Disparities in Outcomes Among Newborns with Congenital Diaphragmatic Hernia: Results from a National Children's Hospital Database."
video11:50 · Feb 2023
BOB Ped Surg 2023 - Shelby Sferra, AAP - Presentation
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Watch Shelby Sferra, MD, present her presentation on "Racial and Ethnic Disparities in Outcomes Among Newborns with Congenital Diaphragmatic Hernia: Results from a National Children's Hospital Database."
video5:10 · Feb 2023
Case-Based Journal Review: Congenital Diaphragmatic Hernia 2023
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It is already public knowledge that thousands of articles on different pathologies are published every day and that it is very difficult to follow them.
In this format we bring you a different way of knowing what is the most up-to-date o
podcast19:20 · Oct 2023
Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study
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David Basurto, Kanokwaroon Watananirun, Anne-Gael Cordier, Juan Otaño, Diane Carriere, Marianna Scuglia, Anna Moraes de Luna Freire Vargas, Jordi Prat, Francesca Maria Russo, Anne Debeer, Cleisson Fábio Andrioli Peralta, Paolo De Coppi, Edu
video0:59 · Oct 2024
Quick Literature Updates Episode 20
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We’re back with 20th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesti
video4:03 · Jun 2025
When there's no diaphragm to sew to medially, make an upside-down U-shaped incision on the pericardium and rotate that down to where the diaphragm would be to begin the repair. — Charlie Stolar, Congenital Diaphragmatic Hernia with Dr. Charlie Stolar · 56:28
Congenital Diaphragmatic Hernia with Dr. Charlie Stolar
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Dr Charlie Stolar discusses key points of CDH with Dr. Todd Ponsky. EDITED BY NICHOLAS BRUNS, MD and IAN GLENN, MD.
podcast1:22:05 · Jan 2019
Congenital Diaphragmatic Hernia with Dr. Charlie Stolar
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Dr Charlie Stolar discusses key points of CDH with Dr. Todd Ponsky. EDITED BY NICHOLAS BRUNS, MD and IAN GLENN, MD.In this episode, Dr. Charles Stolar from Columbia University College of Physicians and Surgeons and California Pediatric Sur
podcast1:22:05 · Dec 2020
Update Course Rewind: 2024 Top Ten Key Takeaways
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Join us for a highlight reel of the Top 10 Key Takeaways from the 12th Annual Update Course in Pediatric Surgery. This session covers the latest advances, practical tools, and emerging trends that are shaping the future of pediatric surgica
video18:01 · Jun 2025
Independent predictors of survival after FETO are initial lung size prior to operation, gestational age at delivery, and ability to remove balloon in utero at least 24 hours before birth. — Jan Deprest, Fetoscopic endoluminal tracheal occlusion and twin-twin transfusion: Fetal... · 13:44
Fetoscopic endoluminal tracheal occlusion and twin-twin transfusion: Fetal...
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Dr. Yan Deprest, Professor of Obstetrics GYN, University Hospitals Gasthuisberg. Leuven, Belgium, discusses fetoscopic endoluminal tracheal occlusion. His presentation provides insight on the percutaneous procedure, trocar insertion, delive
video2:29:16 · Jan 2019
What is Congenital Diaphragmatic Hernia (CDH)? An ERNICA animation for parents and families
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Animation video [in English]. Target audience: Parents and families. The video could also be used as an explanatory tool by healthcare professionals.
For further details about this condition, possible complications and specialised care,
video3:14 · Dec 2023
Transition of Care - Alcohol and Smoking
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Animation video on Alcohol and Smoking, from the video series 'Transition of Care'. ERNICA (https://ern-ernica.eu/) Target audience: Healthcare providers
video4:00 · Nov 2023
Expert statements from the recordings in this collection.
Congenital Diaphragmatic Hernia with Dr. Charlie Stolar
CDH occurs in approximately 1 out of every 3,000-4,000 pregnancies
Charlie Stolar2:45
CDH diagnosis is typically made at the 20-week anatomy scan when ultrasonographers see the stomach in the same cross-sectional plane as the heart
Charlie Stolar3:37
CDH represents a growth arrest of both lungs, with the ipsilateral side more severely affected than the contralateral side
Charlie Stolar4:14
At birth, CDH lungs are affected by a mix of pulmonary hypoplasia and altered pulmonary vascular resistance with altered transitional circulation
Charlie Stolar4:23
CDH is a field defect; the most common neonatal comorbidity is foregut motility difficulty
Charlie Stolar4:39
CDH is a medical physiologic emergency but not a surgical emergency
Charlie Stolar5:00
The diagnosis of CDH alone is not an indication for cesarean section; elective spontaneous vaginal delivery is recommended assuming no obstetric issues
Antenatal interventions for CDH are no better than investigational and experimental at best
Babies with CDH should be born at a full-service children's facility with ECMO capability; maybe 10-15% will benefit from ECMO
In single-center experiences, presence of liver in the chest or stomach in the chest is of no prognostic value
Charlie Stolar8:31
Lung-to-head ratio is of limited prognostic value except when very low (less than 0.8), where prognosis is concerning
Charlie Stolar8:42
Associated congenital heart disease and central nervous system abnormalities augur for poor prognosis
Charlie Stolar9:07
If shown 100 children with CDH, 80-85% will survive to become teenagers
Charlie Stolar10:13
Antenatal steroids have tremendous value for preterm labor under 35 weeks but most CDH babies are near-term (37-39 weeks) where steroid role is arguable
Charlie Stolar10:37
Exit to ECMO for CDH is nonsense; it moves the goalposts on almost certainly non-viable babies
We are born with about 1/2 to 2/3 of our full complement of alveoli and can grow the balance sometime after birth
Charlie Stolar13:00
Initial evaluation of newborn with CDH includes looking for morphology, associated anomalies, respiratory distress, pre- and post-ductal oxygen gradients, and early cardiac echo for right heart function
Charlie Stolar14:45
Not every baby with CDH needs or is a candidate for ECMO; approximately 5% have insufficient lung to support life based on inability to saturate preductal blood
Charlie Stolar15:55
ECMO is a drug delivery system for oxygen; indication is when end organs aren't getting enough oxygen despite best care
Charlie Stolar17:06
The best way to assess end-organ function is urine output
Charlie Stolar17:44
ECMO indication is typically oxygenation index in excess of 40 for 4 hours or more
All therapy is guided by preductal oximetry, not postductal; if preductal saturation is 90% (PaO2 ~65 torr), the brain is doing fine with fetal hemoglobin
Charlie Stolar19:06
When managing dropping preductal saturation, first ensure adequate hemoglobin and circulating volume, then increase FiO2 or ventilator pressure, but avoid trying to control PCO2 as this will destroy the lungs
Charlie Stolar20:25
Neonatal ventilators would be thrown out as lethal devices if someone tried to invent them today
CDH babies are not paralyzed during ventilation; minimal sedation is used and babies should be awake and breathing spontaneously
Charlie Stolar21:56
Initial conventional ventilator settings (IMV rate ~40, peak pressure 25-28, PEEP ~5) are not tolerated by most CDH babies
Charlie Stolar22:15
Unconventional ventilation mode for CDH uses high rate (100 breaths/min), low peak pressure (turned down to zero due to stacking), and high gas flow rate with permissive hypercapnia
Charlie Stolar22:53
High-frequency oscillatory ventilation (HFOV) as rescue therapy rarely spares CDH babies from ECMO; when they get out the oscillator, it's time to prime an ECMO circuit
Charlie Stolar24:30
Nitric oxide is a waste of money for CDH; it's terrific for premature babies with immature lung disease but of no value in CDH
The best drug for CDH is oxygen