Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan

Abstract

ECMO is used to treat PPHN starting from an early period after birth, but the mortality and morbidity are not favorable. For lowest OI, the index used to predict survival following ECMO, the cut-off was 15.

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

“…Thus, we think that some degree of selection bias affected the higher mortality of the ECMO group. This tendency in treatment strategies is observed in another study in Japan 33)…”

Extracorporeal membrane oxygenation in 61 neonates: Single‐center experience

“…This was mainly due to the poorer outcome of the present CDH infants compared with the 2012 ELSO registry report: SHD rate was only 31% (5/16) for CDH in the present study, while it was approximately 50% in the 2012 ELSO registry report. 5 Among newborn Japanese CDH infants treated with ECMO, survival >90 days after birth was reported in 37% (16/37) of isolated CDH infants without other anomalies, 6 consistent with the 36% (5/14) in the present study. This suggests that revision of indications for ECMO in CDH is required in Japan.…”

“…Until July 2011, nearly 51 000 patients were registered at the ELSO, and neonatal ECMO accounted for approximately 50% of all cases . Given, however, that no registry system has been available in Japan, reports on the outcome of neonatal ECMO have been limited; to our knowledge, only one report is available in English addressing the outcomes of newborn Japanese infants treated with ECMO for congenital diaphragmatic hernia (CDH) . Accordingly, we retrospectively reviewed the outcome of all newborn infants treated with ECMO over the past 21 years at a single center.…”

Cardiac fetal ultrasonographic parameters for predicting outcomes of isolated left-sided congenital diaphragmatic hernia

“…Third, our indication for ECMO is different from that in Western countries. We rarely chose ECMO for the treatment of severe CDH and did not repair diaphragm hernias on ECMO because the mortality and morbidity of CDH patients requiring ECMO were not favorable in Japan, which was reported in a recent nationwide survey [23]. The early introduction of ECMO or diaphragm hernia repair on ECMO might have had some influences on the outcomes of severe CDH.…”