EXTRACORPOREAL MEMBRANE-OXYGENATION - SUCCESSFUL TREATMENT OF PERSISTENT FETAL CIRCULATION FOLLOWING REPAIR OF CONGENITAL DIAPHRAGMATIC-HERNIA

Abstract

Four neonates (3 having undergone repair of a congenital diaphragmatic hernia and developing a persistent fetal circulatory pattern and 1 having severe infant respiratory distress syndrome) were supported with prolonged extracorporeal membrane oxygenation (ECMO). Three have survived. The pattern of persistent fetal circulation in the newborn infant who has undergone repair of a diaphragmatic hernia apparently can be successfully managed with ECMO even when efforts to lower pulmonary hypertension and improve oxygenation with vasodilators (tolazoline, phenothiazine, acetylcholine or prostaglandin E1) were ineffective. The effectiveness and safety of ECMO is convincing enough to warrant its consideration as therapy for congenital diaphragmatic hernia and persistent fetal circulation prior to the use of vasodilators.