Original articleFactors associated with survival in infants with congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation: a report from the Congenital Diaphragmatic Hernia Study Group
Section snippets
Materials and methods
Cases of congenital diaphragmatic hernia submitted to the congenital diaphragmatic hernia study group from January of 1995 through December 2004 were included. The hospitals participating in this program included 82 centers that provided standardized information to the CDHSG database maintained at Hermann Hospital in Houston, Tex. The database includes numerous measurements describing the perinatal period, the surgical repair used, and details of the ECMO clinical course. We considered chiefly
Results
Data on 3100 patients with CDH were submitted to the Congenital Diaphragmatic Hernia Study Group between January 1995 and December 2004. Of these, 1063 patients (34%) were identified as having been managed with ECMO. Of children treated with ECMO, 160 (15%) did not undergo repair, and all died, leaving 903 cases treated with ECMO in whom repair was undertaken. Thus, overall survival for the entire cohort of children with CDH receiving ECMO was 48%; for those in whom surgical repair was
Discussion
Since the advent of ECMO, several studies have been published supporting both survival advantages [4], [16], [17] and lack of benefits [18], [19] of ECMO for patients with CDH. Few studies have attempted to find predictors of outcome in patients with CDH on ECMO [8], [9], [10], [11], [12]. In an attempt to determine which patients have cardiopulmonary disease incompatible with life, the selection criteria including liver position, prenatal magnetic resonance imaging lung volume measurements,
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