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Articles in Press | JSSICM
Congenital Diaphragmatic Hernia (CDH) Needing Extracorporeal Membrane Oxygenation (ECMO): Early and Long-Term Outcomes of a High-Volume Tertiary Referral Hospital Over 21 Years
Zia BB, Paraboschi I, Thiruchelvam T, Muthialu N, Cross K, De Coppi P, Curry JI, Loukogeorgakis S, Mullaserry D, Blackburn S and Giuliani S*
Zia BB, Paraboschi I, Thiruchelvam T, et al. Congenital diaphragmatic hernia (CDH) needing extracorporeal membrane oxygenation (ECMO): early and long-term outcomes of a high-volume tertiary referral hospital over 21 years. Series Surg Intensive Care Med. 2025;1(1):1-13.
Introduction: We present early and long-term outcomes of infants born with congenital diaphragmatic hernia (CDH) who received extracorporeal membrane oxygenation (ECMO).
Materials and Methods:CDH neonates treated with ECMO from 1st January 2000 to 31st December 2021 were included. Demographics and postnatal data were obtained. 1-year and long-term outcomes were: mortality, length of hospital stay (LOS), recurrence, readmission, ECMO-related adverse events, and surgical complications. Median, interquartile range, and percentages were used. Institutional audit registration (IR3952).
Results: 58/392 (14.8%) patients received ECMO. 25/58 (43.1%) were female. Median birth weight was 2.92 kg (IQR 2.760 - 3.230). 47/58 (81.0%) neonates underwent surgical repair of the diaphragmatic defect (thoracoscopic, n = 6, 12.7%; open repair, n = 41, 87.2%). 42/47 (89.3%) patients were repaired within a median of 144 h (IQR 80 - 270) after ECMO decannulation. 37/47 (78.7%) patients survived after the surgical repair and were discharged home at a median of 33 days (IQR: 16 - 37) after surgery. At 1 year the outcomes were: 1 death from persistent pulmonary hypertension at 5 months after discharge, total re-admissions were 16/37 (43.2%), hernia recurrence in 2 (5.4%) infants, feeding difficulties secondary to gastroesophageal reflux in 4 (10.8%) children, and 2 (5.4%) required a Nissen fundoplication. Long-term follow-up duration after initial hospital discharge was 7.2 years (IQR 6.5 - 9.8).
