Congenital Diaphragmatic Hernia with Dr. Charlie Stolar

January 13, 2017

Dr Charlie Stolar discusses key points of CDH with Dr. Todd Ponsky. EDITED BY NICHOLAS BRUNS, MD and IAN GLENN, MD.

Play from the beginning (00:00)
Antenatal consultation (01:49)
Where should the baby be born? (07:14)
Prognosis (08:06)
Antenatal steroids (10:26)
Congenital Diaphragmatic Hernia with Dr. Charlie Stolar (12:00)
EXIT to ECMO (12:01)
Neonatal evaluation (14:20)
Timing of ECMO (15:40)
Indications for ECMO (17:47)
Ventilatory management (20:13)
When can you transition to HFOV? (24:06)
Nitric oxide (25:42)
Contraindications to ECMO (26:10)
V-A versus V-V ECMO (30:13)
Optimal cannula placement (32:08)
ECMO management (34:14)
Weaning off ECMO (36:24)
How long is too long for ECMO? (37:28)
Why repair just before coming off of ECMO? (40:15)
How do you decide when ECMO is futile? (43:14)
When do you repair the child that does not need ECMO? (45:30)
Cardiovascular variables for operative timing (46:40)
Preoperative preparation (47:41)
Open vs MIS approach (48:16)
Laparotomy technique (54:41)
Thoracoscopic technique (59:19)
Hernia sac vs eventration (01:03:39)
Postoperative chest tube? (01:06:07)
Postoperative management (01:08:44)
Foregut dysmotility (01:09:30)
Multi-disciplinary clinic (01:12:04)
Management of a recurrence (01:14:56)
Right-sided hernias (01:17:45)
Closing remarks (01:20:38)