During ventilation of an infant with congenital diaphragmatic hernia, what precaution should be exercised?

In managing an infant with congenital diaphragmatic hernia (CDH), it is crucial to minimize ventilatory pressures during mechanical ventilation. This is because increased airway pressure can exacerbate respiratory compromise due to the herniated abdominal contents impeding lung expansion. By lowering the ventilatory pressure, one can help reduce the risk of further lung injury and barotrauma, facilitating better overall pulmonary function and gas exchange.

In the context of CDH, excessive pressure can lead to increased intrathoracic pressure, which can hinder venous return and subsequently affect cardiovascular stability. Lowering ventilatory pressures is aimed at maintaining adequate ventilation while minimizing these harmful effects, thus making it a vital precaution in this scenario.

High-frequency oscillation, although useful in certain contexts, may not be the primary consideration for basic single-lung protection in this case. Similarly, bag-mask ventilation might pose challenges in maintaining adequate pressure and could lead to further complications in a patient already struggling with respiratory mechanics. It's important to always prioritize strategies that support lung health and stability without introducing additional risk factors.