Because babies with congenital diaphragmatic hernia (CDH) have underdeveloped, or hypoplastic, lungs, they often are unable to breathe at birth. Moreover, the lack of adequate blood vessels in hypoplastic lung tissue results in inadequate blood flow, causing high blood pressure in the lungs—a dangerous condition called pulmonary hypertension. Because of these critical problems, many newborns with CDH require help breathing from a ventilator. 

Ventilators have traditionally been able to sustain about half of babies long enough to undergo and recover from surgery to repair their hernias, and eventually to develop adequate lung tissue and breathe independently. Those administering the ventilation have strived to achieve normal blood levels of oxygen and carbon dioxide by forcing the correct pressure into these tiny babies' lungs. But the application of too much pressure can damage undeveloped lungs, leading to sometimes serious, even fatal, chronic lung disease. 

Now, a technique called "kinder and gentler ventilation" has proven superior to the traditional approach. Developed by Jen-TienWung, MD, Director, Neonatal Respiratory Care, gentle ventilation seeks to apply the minimum level of respiratory support needed, rather than to achieve normal blood levels of oxygen. Dr. Wung began using lower ventilation pressures in babies with CDH after he observed that lower pressures significantly improved survival among babies who aspirated meconium. 

Today, the survival rate for babies who receive ventilator support at the Morgan Stanley Children's Hospital Neonatal Intensive Care Unit is almost 90%, compared to the national average of 50-60%.