Respiratory management of the newborn with an omphalocele

Despite advances in neonatal care, infants with omphalocele have a mortality rate ranging between 5% and 25%. Respiratory insufficiency is a common clinical chal‐ lenge and an independent predictor of mortality in these infants. The causes of respiratory failure are diverse and are not well understood. This chapter discusses the unique aspects of respiratory management in omphalocele infants. The authors have chosen references in this chapter with appropriate sample size, variable comparisons, regression analyses, and documented median follow-up times. Omphalocele is rare; therefore, the case reports of chapter references have important information. Omphalocele infants are sometimes born with inadequate lung volume to support survival. Prenatal predictors of pulmonary hypoplasia are discussed in the context of fetal magnetic resonance imaging (MRI) and postnatal clinical-radiologic correlation studies. Two recent retrospective articles explain the unique aspects of pulmonary hypertension in omphalocele infants and distinguish it from pulmonary hypoplasia. The avoidance of abdominal compartment syndrome at the time of omphalocele closure is discussed. Clinical strategies that improve the respiratory care of these infants, based on Specific definitions and diagnoses, may reduce the high mortality rate. lung the role of the influence of (GERD),