Four Cases of Extracorporeal Membrane Oxygenation for Congenital Diaphragmatic Hernia.

Kim,  Bo Eun; Ha,  Eun Ju; Kim,  Young A; Kim,  Seonguk; Park,  Jeong Jun; Yun,  Tae Jin; Kim,  Dae Yeon; Kim,  Seong Chul; Lee,  Byong Sop; Kim,  Ellen A; Kim,  Ki Soo; Pi,  Soo Young; Park,  Seong Jong

Case Report

Journal of the Korean Society of Neonatology 2009;16(1):64-70.
Published online May 1, 2009.

Four Cases of Extracorporeal Membrane Oxygenation for Congenital Diaphragmatic Hernia.

Bo Eun Kim, Eun Ju Ha, Young A Kim, Seonguk Kim, Jeong Jun Park, Tae Jin Yun, Dae Yeon Kim, Seong Chul Kim, Byong Sop Lee, Ellen A Kim, Ki Soo Kim, Soo Young Pi, Seong Jong Park

¹Department of Pediatrics, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. drpsj@amc.seoul.kr
²Department of Thoracic & Cardiovascular Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
³Department of Pediatric Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.

체외막형산소섭취로 치료한 선천성 횡격막 탈장 4례

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Abstract

Congenital diaphragmatic hernia (CDH) with severe pulmonary hypoplasia is associated with significant mortality. Recently, several new therapeutic methods have been suggested, such as high- frequency oscillatory ventilation and inhaled nitric oxide. For hypoxemic respiratory failure unresponsive to these advanced medical treatment options, extracorporeal membrane oxygenation (ECMO) serves as the last potentially effective treatment. An understanding of the pathophysiology of pulmonary hypertension associated with CDH led to a strategy involving preoperative stabilization and delayed surgical intervention with ECMO. We describe four cases of ECMO, including the first report of ECMO for neonatal CDH in Korea.

Key Words: Congenital diaphragmatic hernia; Extracorporeal membrane oxygenation; Respiratory failure; Pulmonary hypertension