| Long-term outcome following extracorporeal membrane oxygenation for congenital diaphragmatic hernia: the UK experience. | |
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MedLine Citation:
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PMID: 15001933 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We 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 ECMO, 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, ECMO 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. |
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Authors:
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Peter J Davis; Richard K Firmin; Brad Manktelow; Allan P Goldman; Carl F Davis; Jon H Smith; Jane V Cassidy; Lara S Shekerdemian |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of pediatrics Volume: 144 ISSN: 0022-3476 ISO Abbreviation: J. Pediatr. Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-03-05 Completed Date: 2004-04-15 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 309-15 Citation Subset: AIM; IM |
Affiliation:
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Heartlink ECMO Centre, Glenfield Hospital, and the Department of Epidemiology, University of Leicester, Leicester, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Apgar Score Birth Weight Cause of Death Comorbidity Developmental Disabilities / etiology Extracorporeal Membrane Oxygenation Hernia, Diaphragmatic / congenital, mortality*, therapy* Humans Infant, Newborn Retrospective Studies Survival Analysis |
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