Table 3

Unchanged recommendations regarding ventilation in CDH47 49–54

Unchanged recommendationsStrength of consensusLevel of evidence
3.1 All newborns with CDH who require respiratory support should be intubated (for assisted ventilation) immediately after birth.4C-EO
3.2 A T-piece on the bag–valve mask, or a ventilator, should be used to rigorously avoid a peak inspiratory pressure (PIP) greater than 25 cm H2O from the first breaths onwards in all newborns with CDH.4B-NR
3.3 Gentle intermittent mandatory ventilation (IMV) should be the initial mode of ventilation for all newborns with CDH requiring respiratory support. High-frequency oscillatory ventilation or high-frequency jet ventilation should be used as rescue therapy when the PIP required to control hypercapnia using IMV exceeds 25 cm H2O.4B-R
3.4 An arterial pCO2 (partial pressure of carbon dioxide) between 45 and 60 mm Hg and a pH between 7.25 and 7.40 should be targeted in all newborns with CDH.4B-NR
3.5 Supplemental oxygen should be titrated to achieve a preductal saturation of at least 85%, but not >95%.4C-EO
  • CDH, congenital diaphragmatic hernia; EO, expert opinion; NR, non-randomised; R, randomised.