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Lookup NU author(s): Dr Jon Smith
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Objective,e evaluated the long-term outcome of neonates receiving extracorporeal membrane oxygenation (ECMO) for congenital diaphragmatic hernia (CDH). Study design A retrospective review of all 73 neonates with CDH supported with ECMO in the United Kingdom between 1991 and 2000. with follow-up to January 2003. Information was from hospital charts and from communication with family doctors and pediatricians. Median follow-up period for survivors was 67 months. Results 46 infants (63%) were weaned from ECHO, 42 (58%) survived to hospital discharge, and 27 (37%) survived to age 1 year or more. A higher birth weight, higher 5-minute Apgar score, and postnatal diagnosis were "pre-ECMO" predictors of long-term survival. Comorbidity was common in long-term survivors: 13 (48%) had respiratory symptoms, 16(59%) had gastrointestinal problems, and 6 (19%) had severe neurodevelopmental problems. Only 7 children were free of significant neurodevelopmental deficit and required no further medical or surgical intervention. Conclusion Using the current referral criteria, ECHO can be used to support the sickest neonates with CDH. However, there is significant mortality in the first year of life, and long-term physical and neurodevelopmental morbidity remains in the majority of survivors.
Author(s): Davis PJ, Firmin RK, Manktelow B, Goldman AP, Davis CF, Smith JH, Cassidy JV, Shekerdemian LS
Publication type: Article
Publication status: Published
Journal: Journal of Pediatrics
Year: 2004
Volume: 144
Issue: 3
Pages: 309-315
ISSN (print): 0022-3476
ISSN (electronic): 1097-6833
Publisher: Mosby, Inc.
URL: http://dx.doi.org/10.1016/j.jpeds.2003.11.031
DOI: 10.1016/j.jpeds.2003.11.031
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