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Improving survival for patients with high-risk congenital diaphragmatic hernia by using extracorporeal membrane oxygenation.

Abstract：

:The benefit of extracorporeal membrane oxygenation (ECMO) in cases of high-risk congenital diaphragmatic hernia (CDH) was studied by comparing pre-ECMO (1987-1990) and post-ECMO (1991-1994) 3-month survival statistics. Fifty-five CDH patients who presented in respiratory distress within 6 hours after birth were referred--18 in the pre-ECMO era and 37 in the ECMO era. During the entire study period (December 1987 through July 1994) the patients were treated by the same protocol of preoperative stabilization and delayed surgery; the only difference was the addition of ECMO beginning in January 1991. The patients were stratified based on the response to conventional treatment: 1, no response (irretrievable); 2, stable; 3, unstable. The 3-month survival rate for the unstable neonates (who could not be stabilized by conventional therapy) improved from 0% (0 of 9) in the pre-ECMO era to 61% (11 of 18) in the ECMO era (P = .004). This highly significant difference shows that ECMO is a very valuable addition to the management of high-risk CDH patients whose conditions remain unstable despite maximal conventional therapy.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

vd Staak FH,de Haan AF,Geven WB,Doesburg WH,Festen C

doi

10.1016/0022-3468(95)90408-5

subject

Has Abstract

pub_date

1995-10-01 00:00:00

pages

1463-7

issue

10

eissn

0022-3468

issn

1531-5037

pii

0022-3468(95)90408-5

journal_volume

30

pub_type

杂志文章

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