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Dear colleagues, We have now 34 weeks girl with mild RDS and right-sided congenital diaphragmatic hernia. Her vitals is stable, RDS is managed well by nasal CPAP. There is a liver in right thorax proven by CT. The Xray is below. My question is should we feed this baby enterally and how? Many thanks.
As a young resident I have a vivid memory of a baby with CDH having saturations of 60 – 65% despite HFOV, paralysis and alkalinization (yes we used to do that). It was at that time that I pretty much threw my hands in the air and declared there was really nothing left that we could do. One of my mentors, a very wise Neonatologist Dr. Henrique Rigatto looked at me and said “why don’t we try inhaled nitric oxide?” Being the resident immersed in the burgeoning field of evidence based medicine I questioned him on this stating “But the evidence shows no benefit of iNO in CDH in any trials”. He