ECMO increases survival in CDH, only in high risk patients
Topic overview
Retrospective cohort study of 5,855 CDH patients found ECMO increases mortality in low-risk cases but improves survival in high-risk neonates (CO2 ≥60 mmHg), particularly at high-volume centers. Results support selective ECMO use based on risk stratification and center experience.
Key takeaways
- ECMO increases mortality in low- and intermediate-risk CDH neonates (47.8% vs 21.8% without ECMO)
- High-risk CDH patients (first-day PaCO2 ≥60 mmHg) show survival benefit with ECMO (64.2% vs 84.4% mortality without)
- ECMO survival advantage in high-risk CDH occurs primarily at high-volume centers with extensive ECMO experience
- Propensity-matched analysis of 5855 ECLS-eligible CDH patients demonstrates risk stratification is critical for ECMO selection
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