Abstract / Summary
Abstract Objective: To develop consensus guidelines for the hemodynamic management of infants with congenital diaphragmatic hernia (CDH).
Methods: A systematic review of the literature on hemodynamic management for infants with CDH was conducted using major databases from January 2000 to November 2023. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. Where evidence was insufficient, expert statements were developed based on the results of a national survey on hemodynamic management practices for infants with CDH. Statements were distributed to members of the Children’s Hospitals Neonatal Consortium (CHNC) CDH Focus Group using three-rounds of modified Delphi methodology.
Results: Consensus was reached on 20 statements addressing baseline physiological assessment, echocardiographic parameters, hemodynamic monitoring, physiology-based phenotyping, and phenotype-based vasoactive management of infants with CDH.
Conclusion: These guidelines provide a consensus-driven and evidence-based framework for the hemodynamic management of infants with CDH. Future studies should assess the impact of guideline implementation and adherence on clinical outcomes.