Ulas KUMBASAR, EMİNE İPEK ÖZBEK SÖNMEZ, Zeynelabidin OZTURK, Recep Oktay PEKER, Saniye EKİNCİ, Benan BAYRAKCİ, Mustafa YİLMAZ, Riza DOGAN
Extracorporeal Membrane Oxygenation for Congenital Diaphragmatic Hernia: A Single Center Experience in Turkey
Objective: Extracorporeal membrane oxygenation is a temporary life-support modality offered for stabilizing neonates with congenital diaphragmatic hernia who are in a critical condition and unresponsive to optimal medical therapy. The aim of this study was to examine our institutional outcomes of early congenital diaphragmatic hernia repair on extracorporeal membrane oxygenation. Materials and Methods: A total of 17 extracorporeal membrane oxygenation-supported patients with congenital diaphragmatic hernia were evaluated and the demographic, diagnostic, laboratory, clinical data, complications and outcome of the patients were reported. Results: The study consisted of 7 females and 10 males. Mean birth weight was 3107 g (range, 2360–3840 g). Median age of extracorporeal membrane oxygenation initiation was 2.1 days. In total four patients received venovenous extracorporeal membrane oxygenation. Other patients received venoarterial extracorporeal membrane oxygenation via aortic and right atrial cannulation. The mean duration of extracorporeal membrane oxygenation was 25 days (range: 1-140 days). Six patients (35.2%) could be weaned from extracorporeal membrane oxygenation. The most common extracorporeal membrane oxygenation related complications were hemorrhage, disseminated intravascular coagulation and limb ischemia (64.7%, 41.1% and 29.4%, respectively). Diaphragmatic defect was repaired via a subcostal incision in 12 of 13 patients. In 88.2% of patients diaphragmatic repair was performed with polytetrafluoroethylene patch. In 77% of patients early congenital diaphragmatic hernia repair was performed concomitantly with extracorporeal membrane oxygenation insertion. The survival rate was 17.6%. Conclusion: Early repair of congenital diaphragmatic hernia in neonates on extracorporeal membrane oxygenation can be associated with high rates of morbidity and mortality. However, extracorporeal membrane oxygenation may be considered a life-saving measure for patients with congenital diaphragmatic hernia who would have otherwise not been salvageable.
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- ISSN: 2147-9488
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2012
- Yayıncı: HACETTEPE ÜNİVERSİTESİ
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