Scholarlink

Background <p>Infants with congenital diaphragmatic hernia (CDH) remain at high risk for ECMO and mortality. We previously reported improved outcomes after implementing new CDH care guidelines. This study reassesses ECMO rates, survival, and guideline adherence to determine if improvements persisted.</p> Methods <p>Retrospective review of all neonatal CDH cases at a single center during pre-guideline (2003–2015, <i>n</i> = 229) and post-guideline (2016–2024, <i>n</i> = 160) periods, with post-guideline subdivided into two epochs: post-1 (2016–2019, <i>n</i> = 70) and post-2 (2020–2024, <i>n</i> = 90).</p> Results <p>Survival without ECMO improved (pre-53%; post-1 74%; post-2 82%; <i>p</i> &lt; 0.001), as did overall survival (72% vs. 83% vs. 86%; <i>p</i> = 0.006). ECMO use decreased (31% vs. 14% vs. 6%; <i>p</i> &lt; 0.001). Inhaled nitric oxide use remained low, and vasoactive medication use dropped significantly in post-2.</p> Conclusion <p>Sustained survival improvement and reduced ECMO use followed guideline changes emphasizing minimal stimulation, gentle ventilation, delayed transfer, pre-ductal saturation monitoring, and limited vasoactive therapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Congenital diaphragmatic hernia: are improvements in ECMO & survival sustainable over time?

  • 期刊论文

  • 发表日期：

    2026年3月13日

查看全文
  • Michelle J. Yang,
  • Ryan J. Carpenter,
  • Christian C. Yost,
  • Anastasia M. Kahan,
  • Stephen J. Fenton,
  • Katie W. Russell,
  • Bradley A. Yoder

摘要

Background

Infants with congenital diaphragmatic hernia (CDH) remain at high risk for ECMO and mortality. We previously reported improved outcomes after implementing new CDH care guidelines. This study reassesses ECMO rates, survival, and guideline adherence to determine if improvements persisted.

Methods

Retrospective review of all neonatal CDH cases at a single center during pre-guideline (2003–2015, n = 229) and post-guideline (2016–2024, n = 160) periods, with post-guideline subdivided into two epochs: post-1 (2016–2019, n = 70) and post-2 (2020–2024, n = 90).

Results

Survival without ECMO improved (pre-53%; post-1 74%; post-2 82%; p < 0.001), as did overall survival (72% vs. 83% vs. 86%; p = 0.006). ECMO use decreased (31% vs. 14% vs. 6%; p < 0.001). Inhaled nitric oxide use remained low, and vasoactive medication use dropped significantly in post-2.

Conclusion

Sustained survival improvement and reduced ECMO use followed guideline changes emphasizing minimal stimulation, gentle ventilation, delayed transfer, pre-ductal saturation monitoring, and limited vasoactive therapy.