The Canadian CDH Collaborative 2.07

This application serves as a comprehensive point-of-care resource for clinicians involved in the management of congenital diaphragmatic hernia (CDH) patients, offering evidence-based and consensus-driven national guidelines. The guidelines encompass the entire spectrum of care, from prenatal diagnosis to hospital discharge and subsequent post-discharge surveillance. It is designed for all stakeholders involved in CDH patient care, including specialty and primary medical providers, allied health professionals, and families.

The app is systematically organized into distinct sections that align with the various phases of care. Each phase presents recommendations accompanied by an indication of the level of evidence and the strength of expert consensus. Additionally, users will find concise descriptions of the evidence supporting each recommendation, along with a list of references for further exploration.

One of the primary objectives of disseminating these guidelines is to enhance the quality of health care delivery for CDH patients by establishing optimal performance benchmarks and minimizing unwanted variations in care practices.

In addition to guidelines access, the app offers several supplementary resources that may prove beneficial for care teams managing CDH patients. These resources include:

• A link to the full, unabridged recommendations that delves into a more detailed discussion of the supporting evidence.
• A daily intensive care rounding checklist specifically tailored for CDH patients.
• A guideline compliance tool that enables individual hospitals to monitor their adherence to the guidelines as part of a continuous quality improvement initiative.
• Two calculators that assist in determining the observed-expected lung-to-head ratio (o/e LHR) and the oxygenation index (OI).

The collective is a representative assembly of specialists from across Canada with expertise spanning maternal-fetal medicine, pediatric surgery, pediatric anesthesia, neonatal intensive care, neonatal follow-up, pediatric intensive care, and pediatric cardiology. The steering committee will undertake updates to the recommendations every three years, ensuring that the guidelines remain a dynamic and evolving resource based on emerging evidence.