Potential survival benefit with repair of congenital diaphragmatic hernia (CDH) after extracorporeal membrane oxygenation (ECMO) in select patients: Study by ELSO CDH Interest Group
Author / Expert
Patrick T. Delaplain, Matthew T. Harting, Tim Jancelewicz, Lishi Zhang, Peter T. Yu, Matteo Di Nardo, Yanjun Chen, James E. Stein, Henri R. Ford, Danh V. Nguyen, Yigit Guner
Topic overview
Abstract
Purpose
Studying the timing of repair in CDH is prone to confounding factors, including variability in disease severity and management. We hypothesized that delaying repair until post-ECMO would confer a survival benefit.
Methods
Neonates who underwent CDH repair were identified within the ELSO Registry. Patients were then divided into on-ECMO versus post-ECMO repair. Patients were 1:1 matched for severity based on pre-ECMO covariates using the propensity score (PS) for the timing of repair. Outcomes examined included mortality and severe neurologic injury (SNI).
Results
After matching, 2,224 infants were included. On-ECMO repair was associated with greater than 3-fold higher odds of mortality (OR 3.41, 95% CI: 2.84–4.09, p
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