Congenital diaphragmatic hernia: is the heart the problem?

Congenital diaphragmatic hernia (CDH) continues to be one of the most challenging conditions in neonatal intensive care. Despite the wide adoption of lung protective strategies for pulmonary hypoplasia and selective vasodilators for pulmonary hypertension, the overall number of babies cannulated for extracorporeal support (ECMO) has been largely unchanged over the last decade. Even more puzzling is that randomized trials did not find any benefit of inhaled nitric oxide (iNO) in reducing need for ECMO in babies with CDH.

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