Facharzt FMH Kinderchirurgie Practice Questions - Facharzt FMH Für Kinderchirurgie Spécialiste FMH En Chirurgie Pédiatrique Exam

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A 38-week male infant is born following a pregnancy complicated by an antenatal diagnosis of left-sided congenital diaphragmatic hernia (CDH). In the delivery room, he exhibits severe respiratory distress, cyanosis, and a scaphoid abdomen with bowel sounds auscultated over the left hemithorax. What is the fundamental principle of immediate neonatal delivery room resuscitation for this patient?

Immediate endotracheal intubation avoiding bag-mask ventilation, gentle lung-protective ventilation (peak inspiratory pressure <25 cmH2O, permissive hypercapnia), and placement of a wide-bore nasogastric sump tube Vigorous high-pressure bag-mask ventilation with 100% oxygen to force open the collapsed left lung before attempting intubation Emergent bedside thoracostomy tube placement in the left 5th intercostal space to decompress the herniated bowel Immediate emergency transfer to the operating theater for subcostal laparotomy within the first 60 minutes of life

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