Clinics (Sao Paulo). 2021;76:e3210.

Electrical Impedance Tomography in Congenital Diaphragmatic Hernia

Rafael Gonçalves Comparini , Mario Cicero Falcão , Cíntia Johnston , Werther Brunow de Carvalho

DOI: 10.6061/clinics/2021/e3210

Congenital diaphragmatic hernia (CDH) is a severe defect with an estimated incidence of 1:3000 live births (). This anomalous condition is characterized by an absence of separation between the thoracic and abdominal cavities during fetal development. Some of the first hypotheses about this congenital defect postulated that the presence of abdominal viscera in the thoracic cavity caused pulmonary hypoplasia by pushing the abdominal contents into the developing lungs (,).

After several studies in animal models, a new theory was presented to explain pulmonary hypoplasia in CDH. According to this theory, the initial lesion occurs in the early stages of fetal development and organogenesis, which promotes hypoplasia of both lungs and ipsilateral lung compression by herniation of the abdominal contents. This prevents the branching of bronchi, bronchioles, and pulmonary arteries and veins, resulting in hypoplasia of the pulmonary acini. The terminal bronchioles are reduced and the alveolar septa are thickened, which results in relatively immature lungs and vascular hypoplasia. This theory explains the variability of pulmonary hypoplasia in patients with CDH ().

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