'Revolutionary' treatment for birth defect improves survival of newborns

GAINESVILLE --- The method doctors traditionally use to treat diaphragmatic hernia, a life-threatening birth defect, can actually worsen the lung condition and should be abandoned in favor of a "revolutionary" treatment strategy that dramatically increases the survival chances of affected newborns, University of Florida researchers report in the September issue of the Annals of Surgery.

In a comparative study of new and conventional treatments, UF pediatric surgeons report using a new technique that has allowed 23 of 25 affected newborns delivered and treated at Shands Children's Hospital at UF since 1992 to survive the defect and go home healthy and breathing on their own.

According to UF pediatric surgeon David Kays, the report's lead author, the 92 percent survival rate among those 25 affected babies "is revolutionary" when compared with the national survival rate of between 50 and 60 percent.

About one in 3,500 babies in the United States are born with diaphragmatic hernia, which leaves a hole in their diaphragm muscle that allows their abdominal organs -- such as the stomach, bowels, kidney and liver -- to migrate into their chest. The defect impedes lung capacity and development and also can damage the displaced organs. Newborns who don't survive usually die during the first days or weeks of life.

"Across the country, there are a whole bunch of kids with diaphragmatic hernia who are dying," said Kays, an associate professor of pediatric surgery at UF's College of Medicine. "The main point of our research paper is that standard therapy that has been in use for about 20 years hasn't worked and, in fact, is harmful to these kids."

The new treatment features three key components:

* "Gentle" ventilator therapy -- less aggressive than standard "hyperventilation" -- as an aid to the infant's underdeveloped lungs;

* The use of a heart-lung machine called ECMO, short for extracorporeal membrane oxygenation, which about 40 percent of aff

Contact: Shands HealthCare Public Relations
University of Florida

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