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Pediatric Surgery International

Published in:

01-02-2017 | Original Article

Outcomes of congenital diaphragmatic hernia repair on extracorporeal life support

Authors: Jamie Golden, Nicole Jones, Jessica Zagory, Shannon Castle, David Bliss

Published in: Pediatric Surgery International | Issue 2/2017

Abstract

Purpose

Extracorporeal life support (ECLS) is applied to refractory pulmonary hypertension in congenital diaphragmatic hernia (CDH). We evaluate the single-center outcomes of infants with CDH to determine the utility of late repair on ECLS versus repair post-decannulation.

Methods

Records of infants with CDH (2004–2014) were retrospectively reviewed.

Results

CDH was diagnosed in 177 infants. Sixty six (37%) underwent ECLS, of which, 11 died prior to repair, 33 were repaired post-decannulation, and 22 were repaired on ECLS. Repair was delayed in patients on ECLS (19 versus 10 days, p < 0.001). Patients repaired on ECLS had longer ECLS runs (22 versus 12 days, p < 0.001) and higher rates of bleeding and mortality than those repaired post-decannulation. Survival was 54% in infants undergoing ECLS, 65% in those who underwent repair, 36% in those repaired during ECLS, and 85% in those who were decannulated prior to repair. Eighteen percent (N = 4) of deaths after repair on ECLS were attributable to surgical bleeding. The remainder was due to pulmonary hypertension or sepsis.

Conclusion

Infants who underwent CDH repair post-decannulation had excellent outcomes and no mortalities attributable to repair. Neonates who underwent repair on ECLS late on bypass had the lowest survival rate with only 18% of mortality in this cohort attributable to surgical bleeding.

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Title: Outcomes of congenital diaphragmatic hernia repair on extracorporeal life support
Authors: Jamie Golden
Nicole Jones
Jessica Zagory
Shannon Castle
David Bliss
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 2/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-4002-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes of congenital diaphragmatic hernia repair on extracorporeal life support

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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