Extracorporeal membrane oxygenation ? succesful treatment after repair of congenital diaphragmatic hernia

Nagaya, Masahiro; Tsuda, Mineyuki; Iio, Kenji; Ishiguro, Yukio

doi:10.1007/bf00173455

Cited by 5 publications

(1 citation statement)

References 16 publications

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“…Although a diaphragmatic defect can be easily corrected by pulling out the herniated viscera of the chest and closing the diaphragma, the mortality rate of infants with congenital diaphragmatic hernia is 50-75% (Adzick et al, 1985;Harrison et al, 1990). Various treatments of pulmonary insufficiency in an infant with congenital diaphragmatic hernia have been proposed, for instance, preoperative stabilization with delayed surgery, respiratory alkalosis induced by hyperventilation, treatment with pulmonary vasodilators, pulmonary surfactant, nitric oxide inhalation and extracorporeal circulation with a membrane oxygenator (Bartlett et al, , 1982German et al, 1977;Ein et al, 1980;Fujiwara et al, 1980;Drummond et al, 1981;Loe et al, 1985;Nagaya et al, 1988Nagaya et al, , 1998Lotze et al, 1994;Shah et al, 1994). In addition, at present if an infant with congenital diaphragmatic hernia who does not present with symptoms within the first 24 hours of life will not die; the survival rate is 1008.…”

Section: Congenital Diaphragmatic Hernia In Humansmentioning

confidence: 99%

Congenital Diaphragmatic Hernia: Experimental Approach

Hashimoto

1999

Congenital Anomalies

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Congenital diaphragmatic hernia is the only relatively common congenital malformation which requires operative treatment during the neonatal period, and the incidence is reported to be one in 2,000–5,000 births. Although a diaphragmatic defect can be easily corrected by pulling out the herniated viscera of the chest and closing the diaphragma, the mortality rate of infants with congenital diaphragmatic hernia is high despite improvements in neonatal intensive care, because the hypoplastic lungs on the affected side can not provide life support after birth. The severity of associated pulmonary hypoplasia is the most important factor determining survival in an infant with congenital diaphragmatic hernia. From experimental study, it should be emphasized that retardation in the lung growth, regardless of its potential for further growth, just at the time of pleuroperitoneal canal closure, may result in congenital diaphragmatic hernia; the hypoplastic lung on the side of herniation would not result from the compression of the lung by the herniated organs, but it may be induced by the limited space for further growth.

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