Does extracorporeal membrane oxygenation benefit neonates with congenital diaphragmatic hernia? Application of a predictive equation

Keshen, Tamir H.; Gürsoy, Murat; Shew, Stephen B.; Smith, E O; Miller, Ronna G.; Wearden, Mary E; Moïse, Alicia A.; Jaksic, Tom

doi:10.1016/s0022-3468(97)90627-8

Cited by 42 publications

(47 citation statements)

References 27 publications

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“…Roughly 50% of infants with highrisk CDH are treated with ECMO [25,26], the results, however, remain disappointing [2,21,27]. Some authors reported an improved survival rate when incorporating ECMO as a preoperative stabilization or postoperative rescue therapy [26,28,29], while others found a relatively unchanged mortality rate [2,21,22,27,30].…”

Section: Introductionmentioning

confidence: 99%

“…It is difficult to accurately compare results of those studies because each center varies in degree of illness, ventilatory management, timing of surgery, ECMO and selection criteria for ECMO. Another confounding feature of reports of survival in CDH patients treated with ECMO is the unreliability of historic controls [2,26,27]. Furthermore, most studies have a relatively short follow-up period, while significant late mortality has been found in CDH patients treated with ECMO [31].…”

Section: Introductionmentioning

confidence: 99%

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The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

et al. 2008

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Congenital diaphragmatic hernia (CDH) is a life-threatening anomaly with a mortality rate of approximately 40-50%, depending on case selection. It has been suggested that new therapeutic modalities such as nitric oxide (NO), high frequency oxygenation (HFO) and extracorporal membrane oxygenation (ECMO) might decrease mortality associated with pulmonary hypertension and the sequelae of artificial ventilation. When these new therapies indeed prove to be beneficial, a larger number of children with severe forms of CDH might survive, resulting in an increase of CDH-associated complications and/or consequences. In follow-up studies of infants born with CDH, many complications including pulmonary damage, cardiovascular disease, gastro-intestinal disease, failure to thrive, neurocognitive defects and musculoskeletal abnormalities have been described. Long-term pulmonary morbidity in CDH consists of obstructive and restrictive lung function impairments due to altered lung structure and prolonged ventilatory support. CDH has also been associated with persistent pulmonary vascular abnormalities, resulting in pulmonary hypertension in the neonatal period.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

et al. 2008

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“…Because these interventions require certain experiences and some technological resources such as extracorporeal membrane oxygenation (ECMO) that are not necessarily available in every birthing centers, it has been widely accepted to always deliver prenatally diagnosed CDH infants at high-risk perinatal centers. Maternal transfer is always safer than transfer of an unstable infant (Keshen et al, 1997;Sreenan et al, 2001;Boloker et al, 2002;Nasr et al, 2011). Location of delivery is a significant independent predictor for mortality, with an odds ratio (OR) of dying when outborn of 2.8 (Nasr et al, 2011).…”

Section: Location Of Delivery and Neonatal Transportmentioning

confidence: 99%

“…Low birth weight has been identified as independent risk factors for poor outcomes (Keshen et al, 1997;Congenital Diaphragmatic Hernia Study Group, 2001;Stevens et al, 2002;Skarsgard et al, 2005;Haricharan et al, 2009;Bucher et al, 2010).…”

Section: Mode Of Deliverymentioning

confidence: 99%

Predictors of Mortality and Morbidity in Infants with CDH

Aly¹,

Abdel‐Hady²

2012

Congenital Diaphragmatic Hernia - Prenatal to Childhood Management and Outcomes

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“…In studies of congenital diaphragmatic hernia, MVI has been used to predict prognosis 21,22 and may be better than PCO 2 alone. 23 Blood gases were sampled within 1 h before surfactant administration, and between 1 and 2 h after surfactant administration for each dose, then 12 h after the second dose. Whenever possible, arterial blood gases (ABGs) were obtained.…”

Section: Outcome Assessmentmentioning

confidence: 99%