Akademik Veri Yönetim Sistemi
Acta Medica, cilt.51, sa.2, ss.1-7, 2020 (Hakemli Dergi)
Objective: Extracorporeal membrane oxygenation is a temporary life-support modality offered for stabilizing neonates with congenital diaphragmatic hernia who are in acritical condition and unresponsive to optimal medical therapy. The aim of this studywas to examine our institutional outcomes of early congenital diaphragmatic herniarepair on extracorporeal membrane oxygenation.Materials and Methods: A total of 17 extracorporeal membrane oxygenation-supported patients with congenital diaphragmatic hernia were evaluated and the demographic, diagnostic, laboratory, clinical data, complications and outcome of the patients were reported.Results: The study consisted of 7 females and 10 males. Mean birth weight was 3107g (range, 2360–3840 g). Median age of extracorporeal membrane oxygenation initiation was 2.1 days. In total four patients received venovenous extracorporeal membrane oxygenation. Other patients received venoarterial extracorporeal membraneoxygenation via aortic and right atrial cannulation. The mean duration of extracorporeal membrane oxygenation was 25 days (range: 1-140 days). Six patients (35.2%)could be weaned from extracorporeal membrane oxygenation. The most commonextracorporeal membrane oxygenation related complications were hemorrhage, disseminated intravascular coagulation and limb ischemia (64.7%, 41.1% and 29.4%, respectively). Diaphragmatic defect was repaired via a subcostal incision in 12 of 13 patients. In 88.2% of patients diaphragmatic repair was performed with polytetrafluoroethylene patch. In 77% of patients early congenital diaphragmatic hernia repair wasperformed concomitantly with extracorporeal membrane oxygenation insertion. Thesurvival rate was 17.6%.Conclusion: Early repair of congenital diaphragmatic hernia in neonates on extracorporeal membrane oxygenation can be associated with high rates of morbidityand mortality. However, extracorporeal membrane oxygenation may be considereda life-saving measure for patients with congenital diaphragmatic hernia who wouldhave otherwise not been salvageable.