Research advances in using extracorporeal membrane oxygenation for congenital diaphragmatic hernia
Congenital diaphragmatic hernia(CDH)is the most common indication for neonatal extracorporeal membrane oxygenation(ECMO).In most severe cases,CDH children suffer lethal cardiac and respiratory failures due to pulmonary dysplasia and pulmonary hypertension.Although a few recent retrospective studies have addressed the indications and applications of ECMO,trade-offs between its survival benefits and drawbacks have remained controversial.It could improve the survival rate of CDH babies.With a higher risk of long-term hemorrhagic complications,there is also a lack of multicenter randomized controlled studies.With optimized ventilator management for CDH and dosing of targeted drugs for pulmonary hypertension,medical institutions have become more and more cautious about timing of using ECMO.It is currently indicated for severe CDH at some medical centers and there is no consensus.This review summarizes the latest advances of clinical indications,intubation duration,contraindications,outcomes and controversies of ECMO application for severe CDH.
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