Document Detail


Long-term outcome following extracorporeal membrane oxygenation for congenital diaphragmatic hernia: the UK experience.
MedLine Citation:
PMID:  15001933     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  144     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-05     Completed Date:  2004-04-15     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-15     Citation Subset:  AIM; IM    
Affiliation:
Heartlink ECMO Centre, Glenfield Hospital, and the Department of Epidemiology, University of Leicester, Leicester, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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