Krisa Van Meurs

Publication Details

  • EFFECT OF EXTRACORPOREAL MEMBRANE-OXYGENATION ON SURVIVAL OF INFANTS WITH CONGENITAL DIAPHRAGMATIC-HERNIA JOURNAL OF PEDIATRICS VanMeurs, K. P., Newman, K. D., Anderson, K. D., Short, B. L. 1990; 117 (6): 954-960

    Abstract:

    To determine the effect of extracorporeal membrane oxygenation (ECMO) on the survival of infants with congenital diaphragmatic hernia, we undertook a retrospective review of 31 infants with congenital diaphragmatic hernia treated at Children's National Medical Center. Infants were categorized by means of the Bohn quadrant analysis to determine the impact of ECMO on infants with congenital diaphragmatic hernia and a "poor prognosis." All infants assigned to the Bohn 100% mortality quadrant required ECMO. The survival rate in this group was 86% (6/7) when assessed preoperatively and 67% (6/9) when assessed postoperatively. Comparison of the change occurring in ventilation index and arterial carbon dioxide pressure demonstrated that after repair the clinical condition of 48% of infants deteriorated, 40% improved, and 12% remained unchanged. Of the 12 infants whose condition was worse after surgery, 11 eventually required ECMO. Our review demonstrates that ECMO improved survival significantly in infants with congenital diaphragmatic hernia who had a "poor prognosis" by the criteria of Bohn et al. We recommend consideration of ECMO for all infants with congenital diaphragmatic hernia for whom maximal medical therapy has failed.

    View details for Web of Science ID A1990EM11600025

    View details for PubMedID 2246699

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