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Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series

Since there are no data available on the influence of the time point of ECMO initiation on morbidity and mortality in patients with congenital diaphragmatic hernia (CDH), we investigated whether early initiation of ECMO after birth is associated with a beneficial outcome in severe forms of CDH. All...

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Autores principales: Wegele, Christian, Schreiner, Yannick, Perez Ortiz, Alba, Hetjens, Svetlana, Otto, Christiane, Boettcher, Michael, Schaible, Thomas, Rafat, Neysan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315500/
https://www.ncbi.nlm.nih.gov/pubmed/35883970
http://dx.doi.org/10.3390/children9070986
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author Wegele, Christian
Schreiner, Yannick
Perez Ortiz, Alba
Hetjens, Svetlana
Otto, Christiane
Boettcher, Michael
Schaible, Thomas
Rafat, Neysan
author_facet Wegele, Christian
Schreiner, Yannick
Perez Ortiz, Alba
Hetjens, Svetlana
Otto, Christiane
Boettcher, Michael
Schaible, Thomas
Rafat, Neysan
author_sort Wegele, Christian
collection PubMed
description Since there are no data available on the influence of the time point of ECMO initiation on morbidity and mortality in patients with congenital diaphragmatic hernia (CDH), we investigated whether early initiation of ECMO after birth is associated with a beneficial outcome in severe forms of CDH. All neonates with CDH admitted to our institution between 2010 until 2020 and undergoing ECMO treatment were included in this study and divided into four different groups: (1) ECMO initiation < 12 h after birth (n = 143), (2) ECMO initiation between 12–24 h after birth (n = 31), (3) ECMO initiation between 24–120 h after birth (n = 48) and (4) ECMO initiation > 120 h after birth (n = 14). The mortality rate in the first (34%) and fourth group (43%) was high and in the second group (23%) and third group (12%) rather low. The morbidity, characterized by chronic lung disease (CLD), did not differ significantly in the three groups; only patients in which ECMO was initiated >120 h after birth had an increased rate of severe CLD. Our data, although not randomized and limited due to small study groups, suggest that very early need for ECMO and ECMO initiation > 120 h after birth is associated with increased mortality.
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spelling pubmed-93155002022-07-27 Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series Wegele, Christian Schreiner, Yannick Perez Ortiz, Alba Hetjens, Svetlana Otto, Christiane Boettcher, Michael Schaible, Thomas Rafat, Neysan Children (Basel) Article Since there are no data available on the influence of the time point of ECMO initiation on morbidity and mortality in patients with congenital diaphragmatic hernia (CDH), we investigated whether early initiation of ECMO after birth is associated with a beneficial outcome in severe forms of CDH. All neonates with CDH admitted to our institution between 2010 until 2020 and undergoing ECMO treatment were included in this study and divided into four different groups: (1) ECMO initiation < 12 h after birth (n = 143), (2) ECMO initiation between 12–24 h after birth (n = 31), (3) ECMO initiation between 24–120 h after birth (n = 48) and (4) ECMO initiation > 120 h after birth (n = 14). The mortality rate in the first (34%) and fourth group (43%) was high and in the second group (23%) and third group (12%) rather low. The morbidity, characterized by chronic lung disease (CLD), did not differ significantly in the three groups; only patients in which ECMO was initiated >120 h after birth had an increased rate of severe CLD. Our data, although not randomized and limited due to small study groups, suggest that very early need for ECMO and ECMO initiation > 120 h after birth is associated with increased mortality. MDPI 2022-07-01 /pmc/articles/PMC9315500/ /pubmed/35883970 http://dx.doi.org/10.3390/children9070986 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wegele, Christian
Schreiner, Yannick
Perez Ortiz, Alba
Hetjens, Svetlana
Otto, Christiane
Boettcher, Michael
Schaible, Thomas
Rafat, Neysan
Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title_full Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title_fullStr Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title_full_unstemmed Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title_short Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series
title_sort impact of time point of extracorporeal membrane oxygenation on mortality and morbidity in congenital diaphragmatic hernia: a single-center case series
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315500/
https://www.ncbi.nlm.nih.gov/pubmed/35883970
http://dx.doi.org/10.3390/children9070986
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