Early CDH Repair on ECMO Improves Survival
Topic overview
Multi-center study of 1,170 CDH patients demonstrates that early repair within 72 hours of ECMO cannulation significantly improves survival to decannulation (87.1% vs 78.4%) compared to delayed repair, despite longer ECMO duration. Findings suggest physiologic benefit of early intervention even in higher-risk patients with cardiac defects and thoracic liver herniation.
Key takeaways
- Early CDH repair within 48-72h of ECMO cannulation increases survival to decannulation (87.1% vs 78.4%, p=0.002).
- Early repair patients had higher-risk features (cardiac defects, thoracic liver) yet still showed survival benefit.
- ECMO duration is longer with early repair (240.6h vs 196.8h), but survival advantage persists despite extended support.
- Physiologic benefit of early repair may outweigh risks in select CDH patients requiring ECMO support.
- Timing of CDH repair on ECMO should be individualized; early repair is a viable strategy for improving outcomes.
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