Effect of Extracorporeal Membrane Oxygenation Availability on the Survival of Neonates with Congenital Diaphragmatic Hernia

Authors

  • Emel Okulu Ankara University School of Medicine
  • Ufuk Ates Ankara University School of Medicine
  • Ahmet Kahveci Ankara University School of Medicine
  • Omer Erdeve Ankara University School of Medicine
  • Begum Atasay Ankara University School of Medicine
  • Aydin Yagmurlu Ankara University School of Medicine
  • Huseyin Dindar Ankara University School of Medicine
  • Zeynep Eyileten Ankara University School of Medicine
  • Saadet Arsan Ankara University School of Medicine

DOI:

https://doi.org/10.21699/jns.v8i1.840

Keywords:

Congenital diaphragmatic hernia, Extracorporeal membrane oxygenation, Neonate, Survival INTRODUCTION

Abstract

Objective: Neonatal congenital diaphragmatic hernia (CDH) is one of the major congenital anomalies with high mortality rates. Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for CDH patients who do not respond to conventional ventilation strategies. The aim of this study is to compare the epochs before and after the introduction of neonatal ECMO program and to determine its impact on response and survival of neonates with isolated CDH.

Materials and Methods: Admitted neonates with CDH patients since 2012 were separated into two epochs according to the establishment of ECMO: Pre-ECMO period (January 2012–August 2015) and ECMO period (September 2015–December 2017). The demographic, clinical, and surgical data of the patients were compared between these two periods.

Results: During the study period, a total of 35 neonates with CDH were admitted. Patient characteristics and surgical data were similar in both groups. Need for high-frequency oscillatory ventilation (HFOV) was higher in the pre-ECMO period (P = 0.04). The length of hospitalization was longer in ECMO period (P = 0.01). Three among seven patients who received ECMO survived (43%). Survival rates at the time of discharge were similar in groups (39% vs. 47%, P = 0.625). It was demonstrated that having oxygenation index >40 at first 24 h (odds ratio (OR): 12, 95% Cl 2.37–60.64, P = 0.03) and the ratio of pulmonary artery pressure to systolic pressure > 1 (OR: 6, 95% Cl 1.33–27.04, P = 0.02) increased mortality.

Conclusion: The establishment of neonatal ECMO program was not associated with an improvement in survival of isolated CDH patients. We suggest that better outcomes may be achieved with defining selective criteria for ECMO candidates.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Downloads

Published

2019-01-22

How to Cite

1.
Okulu E, Ates U, Kahveci A, Erdeve O, Atasay B, Yagmurlu A, Dindar H, Eyileten Z, Arsan S. Effect of Extracorporeal Membrane Oxygenation Availability on the Survival of Neonates with Congenital Diaphragmatic Hernia. J Neonatal Surg [Internet]. 2019Jan.22 [cited 2021Feb.25];8(1):1. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/335

Most read articles by the same author(s)