Recent experience with diaphragmatic hernia and ECMO

Charles G Howell, Robyn M Hatley, R. F. Boedy, D. M. Rogers, W. P. Kanto, R. A. Parrish

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

In the past 4 years at the Medical College of Georgia, a total of 74 patients underwent extracorporeal membrane oxygenation (ECMO) with 62 (84%) survivors. Forty-seven of these infants had meconium aspiration syndrome and 11 had diaphragmatic hernia. The use of ECMO, when indicated, after reduction and repair of the diaphragmatic hernia, results in normal oxygen delivery, allows time for pulmonary maturation, and increases survival. A total of 27 referrals for diaphragmatic hernia were studied. Six infants had surgical repair and did not require ECMO. Eleven patients, after surgical repair, were treated with ECMO and seven survived. More importantly 10 patients died before the use of EMCO. Six infants died either before or during transport from referring hospitals and four died while in the delivery room or neonatal unit before ECMO. Of these 10 infants, eight were potential candidates for ECMO. Thirteen of the twenty-seven (48%) infants survived. Seven of eleven (64%) infants who received the benefit of ECMO survived. Eight infants who met the criteria for ECMO died before its use. Had ECMO been used in those eight infants, our data suggests that at least four may have survived. The data from this report support the concept that infants undergoing surgical repair of diaphragmatic hernia, when ECMO is not available, should be referred to an ECMO center in the early postoperative period. Furthermore infants with prenatal diagnosis of diaphragmatic hernia should be delivered at a center where surgical as well as ECMO expertise are available.

Original languageEnglish (US)
Pages (from-to)793-798
Number of pages6
JournalAnnals of Surgery
Volume211
Issue number6
StatePublished - Jan 1 1990

Fingerprint

Extracorporeal Membrane Oxygenation
Diaphragmatic Hernia
Meconium Aspiration Syndrome
Delivery Rooms
Prenatal Diagnosis
Postoperative Period
Survivors
Referral and Consultation

ASJC Scopus subject areas

  • Surgery

Cite this

Howell, C. G., Hatley, R. M., Boedy, R. F., Rogers, D. M., Kanto, W. P., & Parrish, R. A. (1990). Recent experience with diaphragmatic hernia and ECMO. Annals of Surgery, 211(6), 793-798.

Recent experience with diaphragmatic hernia and ECMO. / Howell, Charles G; Hatley, Robyn M; Boedy, R. F.; Rogers, D. M.; Kanto, W. P.; Parrish, R. A.

In: Annals of Surgery, Vol. 211, No. 6, 01.01.1990, p. 793-798.

Research output: Contribution to journalArticle

Howell, CG, Hatley, RM, Boedy, RF, Rogers, DM, Kanto, WP & Parrish, RA 1990, 'Recent experience with diaphragmatic hernia and ECMO', Annals of Surgery, vol. 211, no. 6, pp. 793-798.
Howell CG, Hatley RM, Boedy RF, Rogers DM, Kanto WP, Parrish RA. Recent experience with diaphragmatic hernia and ECMO. Annals of Surgery. 1990 Jan 1;211(6):793-798.
Howell, Charles G ; Hatley, Robyn M ; Boedy, R. F. ; Rogers, D. M. ; Kanto, W. P. ; Parrish, R. A. / Recent experience with diaphragmatic hernia and ECMO. In: Annals of Surgery. 1990 ; Vol. 211, No. 6. pp. 793-798.
@article{acf19adf5b4e448eac7f4dc43cb7ff2d,
title = "Recent experience with diaphragmatic hernia and ECMO",
abstract = "In the past 4 years at the Medical College of Georgia, a total of 74 patients underwent extracorporeal membrane oxygenation (ECMO) with 62 (84{\%}) survivors. Forty-seven of these infants had meconium aspiration syndrome and 11 had diaphragmatic hernia. The use of ECMO, when indicated, after reduction and repair of the diaphragmatic hernia, results in normal oxygen delivery, allows time for pulmonary maturation, and increases survival. A total of 27 referrals for diaphragmatic hernia were studied. Six infants had surgical repair and did not require ECMO. Eleven patients, after surgical repair, were treated with ECMO and seven survived. More importantly 10 patients died before the use of EMCO. Six infants died either before or during transport from referring hospitals and four died while in the delivery room or neonatal unit before ECMO. Of these 10 infants, eight were potential candidates for ECMO. Thirteen of the twenty-seven (48{\%}) infants survived. Seven of eleven (64{\%}) infants who received the benefit of ECMO survived. Eight infants who met the criteria for ECMO died before its use. Had ECMO been used in those eight infants, our data suggests that at least four may have survived. The data from this report support the concept that infants undergoing surgical repair of diaphragmatic hernia, when ECMO is not available, should be referred to an ECMO center in the early postoperative period. Furthermore infants with prenatal diagnosis of diaphragmatic hernia should be delivered at a center where surgical as well as ECMO expertise are available.",
author = "Howell, {Charles G} and Hatley, {Robyn M} and Boedy, {R. F.} and Rogers, {D. M.} and Kanto, {W. P.} and Parrish, {R. A.}",
year = "1990",
month = "1",
day = "1",
language = "English (US)",
volume = "211",
pages = "793--798",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Recent experience with diaphragmatic hernia and ECMO

AU - Howell, Charles G

AU - Hatley, Robyn M

AU - Boedy, R. F.

AU - Rogers, D. M.

AU - Kanto, W. P.

AU - Parrish, R. A.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - In the past 4 years at the Medical College of Georgia, a total of 74 patients underwent extracorporeal membrane oxygenation (ECMO) with 62 (84%) survivors. Forty-seven of these infants had meconium aspiration syndrome and 11 had diaphragmatic hernia. The use of ECMO, when indicated, after reduction and repair of the diaphragmatic hernia, results in normal oxygen delivery, allows time for pulmonary maturation, and increases survival. A total of 27 referrals for diaphragmatic hernia were studied. Six infants had surgical repair and did not require ECMO. Eleven patients, after surgical repair, were treated with ECMO and seven survived. More importantly 10 patients died before the use of EMCO. Six infants died either before or during transport from referring hospitals and four died while in the delivery room or neonatal unit before ECMO. Of these 10 infants, eight were potential candidates for ECMO. Thirteen of the twenty-seven (48%) infants survived. Seven of eleven (64%) infants who received the benefit of ECMO survived. Eight infants who met the criteria for ECMO died before its use. Had ECMO been used in those eight infants, our data suggests that at least four may have survived. The data from this report support the concept that infants undergoing surgical repair of diaphragmatic hernia, when ECMO is not available, should be referred to an ECMO center in the early postoperative period. Furthermore infants with prenatal diagnosis of diaphragmatic hernia should be delivered at a center where surgical as well as ECMO expertise are available.

AB - In the past 4 years at the Medical College of Georgia, a total of 74 patients underwent extracorporeal membrane oxygenation (ECMO) with 62 (84%) survivors. Forty-seven of these infants had meconium aspiration syndrome and 11 had diaphragmatic hernia. The use of ECMO, when indicated, after reduction and repair of the diaphragmatic hernia, results in normal oxygen delivery, allows time for pulmonary maturation, and increases survival. A total of 27 referrals for diaphragmatic hernia were studied. Six infants had surgical repair and did not require ECMO. Eleven patients, after surgical repair, were treated with ECMO and seven survived. More importantly 10 patients died before the use of EMCO. Six infants died either before or during transport from referring hospitals and four died while in the delivery room or neonatal unit before ECMO. Of these 10 infants, eight were potential candidates for ECMO. Thirteen of the twenty-seven (48%) infants survived. Seven of eleven (64%) infants who received the benefit of ECMO survived. Eight infants who met the criteria for ECMO died before its use. Had ECMO been used in those eight infants, our data suggests that at least four may have survived. The data from this report support the concept that infants undergoing surgical repair of diaphragmatic hernia, when ECMO is not available, should be referred to an ECMO center in the early postoperative period. Furthermore infants with prenatal diagnosis of diaphragmatic hernia should be delivered at a center where surgical as well as ECMO expertise are available.

UR - http://www.scopus.com/inward/record.url?scp=0025303308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025303308&partnerID=8YFLogxK

M3 - Article

VL - 211

SP - 793

EP - 798

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -