Table 4

Unchanged recommendations regarding the fundamentals of haemodynamic support in CDH65 67

Unchanged recommendationsStrength of consensusLevel of evidence
4.1 If poor perfusion persists, cardiac function should be assessed by echocardiography.4B-NR
4.2 Hydrocortisone should be used to treat hypotension that responds inadequately to intravenous volume and vasopressor therapy.4B-NR
Updated recommendationsStrength of consensusLevel of evidence
4.3 Treatment of poor perfusion (any combination of capillary refill >3 s, lactate >3 mmol/L, urine output <1 mL/kg/hour) and blood pressure below norms for age should include:
  1. Very judicious administration of crystalloid, if any, and generally not exceeding 20 mL/kg.

  2. Inotropic agents such as dopamine, epinephrine or norepinephrine.

  • CDH, congenital diaphragmatic hernia; NR, non-randomised.