{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:05:27Z","timestamp":1790643927577,"version":"4.1.0"},"reference-count":137,"publisher":"American Academy of Pediatrics (AAP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:p>Congenital diaphragmatic hernia (CDH) presents a complex challenge in neonatal care, requiring tailored pharmacological strategies to manage its distinct cardiorespiratory pathophysiology. CDH is commonly associated with pulmonary hypertension, impaired myocardial function, and adverse cardiorespiratory interactions, contributing to significant morbidity and mortality. Effective pharmacotherapy must address these interconnected factors while minimizing complications or side effects. Despite limited randomized controlled trial data specific to CDH, recent reports highlight the benefits of a precision medicine approach, focusing on individualized treatments based on evolving pathophysiology. Therapeutic interventions primarily involve pulmonary vasodilators, inotropes and vasopressors, prostaglandins, and corticosteroids; each agent has a distinct physiologic effect, and use needs to be tailored to the specific patient pathophysiology. Targeted neonatal echocardiography has emerged as a valuable tool for optimizing treatment decisions by providing real-time insights into ventricular performance and hemodynamic status. In this review, we explore the shift from a generalized pharmacological approach to targeted interventions based on evolving patient physiology. We discuss key therapeutic principles and the role of different drug classes in optimizing the management of infants with CDH throughout their intensive care journey.<\/jats:p>","DOI":"10.1542\/neo.26-10-060","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:03:33Z","timestamp":1759277013000},"page":"e660-e678","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacology in Congenital Diaphragmatic Hernia: A Focus on Cardiovascular Management"],"prefix":"10.1542","volume":"26","author":[{"given":"Anie","family":"Lapointe","sequence":"first","affiliation":[{"name":"1Division of Neonatology, CHU Sainte-Justine, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Kipfmueller","sequence":"additional","affiliation":[{"name":"2Department of Neonatology and Pediatric Intensive Care Medicine, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Patel","sequence":"additional","affiliation":[{"name":"3Department of Neonatology, Royal Hospital for Children, Glasgow, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Altit","sequence":"additional","affiliation":[{"name":"4Division of Neonatology, Montreal Children\u2019s Hospital, McGill University Health Centre Research Institute, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"4","key":"2025102913013065200_r1","doi-asserted-by":"crossref","first-page":"151437","DOI":"10.1016\/j.sempedsurg.2024.151437","article-title":"Congenital diaphragmatic hernia-associated pulmonary hypertension","volume":"33","author":"Holden","year":"2024","journal-title":"Semin Pediatr 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