BACKGROUND: Neonatal extracorporeal membrane oxygenation (ECMO) is not available in Hong Kong. OBJECTIVES: To document the survival of neonates with symptomatic congenital diaphragmatic hernia at birth, but without access to ECMO. METHODS: Twenty-two patients diagnosed to have CDH within a ten year period (1999-2009) at Prince of Wales Hospital were systematically reviewed. CDH patients who presented after the neonatal period were excluded. RESULTS: There were 17 neonates with symptomatic CDH at birth and the overall survival, including infants with multiple anomalies, was 14/17 (82%). 6 of 17 (35%) infants met the ECMO criteria and the survival rate for these serious cases was 4/6 (67%). CONCLUSIONS: Our results are comparable with centers which provide ECMO and suggest that there may be only marginal benefit for using ECMO to improve survival. A territory-wide registry for documenting risk factors and outcomes would be important, especially in light of improving neonatal intensive care and survival.
BACKGROUND: Neonatal extracorporeal membrane oxygenation (ECMO) is not available in Hong Kong. OBJECTIVES: To document the survival of neonates with symptomatic congenital diaphragmatic hernia at birth, but without access to ECMO. METHODS: Twenty-two patients diagnosed to have CDH within a ten year period (1999-2009) at Prince of Wales Hospital were systematically reviewed. CDH patients who presented after the neonatal period were excluded. RESULTS: There were 17 neonates with symptomatic CDH at birth and the overall survival, including infants with multiple anomalies, was 14/17 (82%). 6 of 17 (35%) infants met the ECMO criteria and the survival rate for these serious cases was 4/6 (67%). CONCLUSIONS: Our results are comparable with centers which provide ECMO and suggest that there may be only marginal benefit for using ECMO to improve survival. A territory-wide registry for documenting risk factors and outcomes would be important, especially in light of improving neonatal intensive care and survival.
Authors: David W Kays; Saleem Islam; Joy M Perkins; Shawn D Larson; Janice A Taylor; James L Talbert Journal: J Pediatr Surg Date: 2015-03-14 Impact factor: 2.545