The acid-base balance and gas-exchange mechanisms and their correlation with the pathologic findings in the lungs of children with diaphragmatic hernia determines prognostic and therapeutic criteria. The existence of a severe respiratory acidosis that does not improve after positive-pressure mechanical ventilation and the existence of a high degree of arteriovenous shunting are bad prognostic signs. The initial laboratory data and their modification after intensive mechanical ventilation are useful in establishing prognosis and in guiding therapy.
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