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Journal of perinatology : official journal of the California Perinatal Association
May, 2024;44 (5): 694-701.

A clinical consensus guideline for nutrition in infants with congenital diaphragmatic hernia from birth through discharge.

Patrick Sloan, Sandy Johng, John M Daniel, Christopher J Rhee, Burhan Mahmood, Evangelia Gravari, Susan Marshall, Ann G Downey, Katie Braski, Sharada H Gowda, Caraciolo J Fernandes, Vedanta Dariya, Beth E Haberman, Ruth Seabrook, Abhishek Makkar, Brian W Gray, Michael W Cookson, Tasnim Najaf, Natalie Rintoul, Holly L Hedrick, Robert DiGeronimo, Mark F Weems, Anne Ades, Rachel Chapman, Theresa R Grover, Sarah Keene
Author Information
  1. Patrick Sloan: Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8116, St. Louis, MO, 63110-1093, USA. sloan.patrick@wustl.edu. ORCID
  2. Sandy Johng: Department of Pediatrics, Division of Neonatology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
  3. John M Daniel: Department of Pediatrics, Division of Neonatology, University of Missouri Kansas School of Medicine, Kansas City, MO, USA.
  4. Christopher J Rhee: Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. ORCID
  5. Burhan Mahmood: Department of Pediatrics, Division of Newborn Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. ORCID
  6. Evangelia Gravari: Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN, USA.
  7. Susan Marshall: Children's Hospital Colorado, Aurora, CO, USA.
  8. Ann G Downey: Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN, USA.
  9. Katie Braski: Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN, USA.
  10. Sharada H Gowda: Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
  11. Caraciolo J Fernandes: Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. ORCID
  12. Vedanta Dariya: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  13. Beth E Haberman: Department of Pediatrics, Division of Neonatology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
  14. Ruth Seabrook: Department of Pediatrics, Division of Neonatology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. ORCID
  15. Abhishek Makkar: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. ORCID
  16. Brian W Gray: Department of Surgery, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA. ORCID
  17. Michael W Cookson: Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA. ORCID
  18. Tasnim Najaf: Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8116, St. Louis, MO, 63110-1093, USA.
  19. Natalie Rintoul: Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  20. Holly L Hedrick: Department of Pediatric General Thoracic and Fetal Surgery Children's Hospital of Philadelphia Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  21. Robert DiGeronimo: Department of Pediatrics, Division of Neonatology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA. ORCID
  22. Mark F Weems: Division of Neonatology and Le Bonheur Children's Hospital, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA. ORCID
  23. Anne Ades: Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  24. Rachel Chapman: Department of Pediatrics, USC Keck School of Medicine, Fetal & Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
  25. Theresa R Grover: Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
  26. Sarah Keene: Division of Neonatal-Perinatal Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
PMID: 38627594 DOI: 10.1038/s41372-024-01965-9

Abstract

OBJECTIVE: To develop a consensus guideline to meet nutritional challenges faced by infants with congenital diaphragmatic hernia (CDH).
STUDY DESIGN: The CDH Focus Group utilized a modified Delphi method to develop these clinical consensus guidelines (CCG). Topic leaders drafted recommendations after literature review and group discussion. Each recommendation was sent to focus group members via a REDCap survey tool, and members scored on a Likert scale of 0-100. A score of > 85 with no more than 25% outliers was designated a priori as demonstrating consensus among the group.
RESULTS: In the first survey 24/25 recommendations received a median score > 90 and after discussion and second round of surveys all 25 recommendations received a median score of 100.
CONCLUSIONS: We present a consensus evidence-based framework for managing parenteral and enteral nutrition, somatic growth, gastroesophageal reflux disease, chylothorax, and long-term follow-up of infants with CDH.

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MeSH Term

Humans
Hernias, Diaphragmatic, Congenital
Infant, Newborn
Consensus
Delphi Technique
Infant
Gastroesophageal Reflux
Enteral Nutrition
Parenteral Nutrition
Chylothorax
Patient Discharge
Journal Article Practice Guideline

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