CHERUBS - Congenital Diaphragmatic Hernia Research - The Latest CDH Procedures & Treatments

Genetic engineers are now creating diaphragm tissue in petri dishes using stem cells. Human trials of using this tissue to repair CDH have not yet begun.
In utero repair of CDH has been replaced by Tracheal Occlusion, which has a higher success rate and a lower rate of premature labor.
EXIT to ECMO is becoming more common. It is a procedure that places the baby on ECMO immediately after birth before the baby can take a breath of his or her own.
Gentle Ventilation is now more often used in replace of more invasive High Frequency Oscillation ventilation.
At least 7 hospitals in the United States now have clinics for children born with CDH; Boston Children's Hospital, University of California in San Francisco, Philadelphia Children's Hospital, Shands in Gainesville, Fetal Care Center of Cincinnati, Vanderbilt University Medical Center, and Women & Infants' Hospital Of Rhode Island.
Some expectant moms are now given steroids in order to help fetal lung growth. Betamethazone Steroid Treatments are now used to help stimulate fetal lung growth by administering injections to expectant CDH moms.
ECMO is still largely used among CDH patients, although in some cases patients are being treated with Nitric Oxide instead (depending on individual patient status).
A CDH study group was formed in 1995 to collect data from multiple institutions in North America, Europe, and Australia.
A new tiny transmitter has been invented in order to help monitor uterine activity after fetal surgery and for high risks labor to help diagnose fetal distress.
A study has shown a possible link between vitamin A deficiency and CDH.
The combination of CDH and ECMO may be a strong predictor of hearing loss. Some antibiotics are also known to cause hearing issues in newborns.
There is a promising new method in tracheal occlusion (also called "tracheal ligation"- it involves injected collagen into the unborn baby's trachea, forcing the lungs to grow and organs to move down. This procedure would eliminate surgery for mom and remove the threat of preterm labor.
Tracheal ligation has been shown to cause lung growth, but may also delay lung maturity due to a decrease in surfactant protein.
In an effort to more accurately monitor preterm labor after fetal surgery, doctors at UCSF are working with NASA to develop techniques for monitoring labor very precisely. The most promising idea is a small capsule that remains in the amniotic space continuously transmitting the intrauterine pressure.
With the help of "Liquid Ventilation," (Perflubron), doctors hope to improve the outcome of CDH babies so critically ill that they require prolonged mechanical ventilation and or ECMO.
In a recent study, it has been found that diaphragmatic agenesis (absence of the diaphragm) was inherited in an autosomal recessive manner.
ECMO remains a common therapy among CDH patients. A study to analyze these patients requiring preoperative ECMO was conducted. The findings suggest that the main pathology of these patients was a high degree of pulmonary hypoplasia.
Recurrent herniation is a problem for many CDH patients. In a recent study, factors shown to attribute to this problem were large-patch repaired defects and right-sided defects.
A new ventilator that improves C02 removal in fetal lambs with CDH is now being tested on humans.