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J Pediatr. 2004 Mar;144(3):309-15.

Long-term outcome following extracorporeal membrane oxygenation for congenital diaphragmatic hernia: the UK experience.

Author information

1
Heartlink ECMO Centre, Glenfield Hospital, and the Department of Epidemiology, University of Leicester, Leicester, United Kingdom.

Abstract

OBJECTIVE:

We evaluated the long-term outcome of neonates receiving extracorporeal membrane oxygenation (ECMO) for congenital diaphragmatic hernia (CDH). Study design A retrospective review of all 73 neonates with CDH supported with ECMO in the United Kingdom between 1991 and 2000, with follow-up to January 2003. Information was from hospital charts and from communication with family doctors and pediatricians. Median follow-up period for survivors was 67 months.

RESULTS:

46 infants (63%) were weaned from ECMO, 42 (58%) survived to hospital discharge, and 27 (37%) survived to age 1 year or more. A higher birth weight, higher 5-minute Apgar score, and postnatal diagnosis were "pre-ECMO" predictors of long-term survival. Comorbidity was common in long-term survivors: 13 (48%) had respiratory symptoms, 16(59%) had gastrointestinal problems, and 6 (19%) had severe neurodevelopmental problems. Only 7 children were free of significant neurodevelopmental deficit and required no further medical or surgical intervention.

CONCLUSION:

Using the current referral criteria, ECMO can be used to support the sickest neonates with CDH. However, there is significant mortality in the first year of life, and long-term physical and neurodevelopmental morbidity remains in the majority of survivors.

PMID:
15001933
DOI:
10.1016/j.jpeds.2003.11.031
[Indexed for MEDLINE]

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