Journal of pediatric surgery
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Congenital diaphragmatic hernia (CDH) with severe respiratory failure in the first few hours of life continues to be associated with significant mortality. Extracorporeal membrane oxygenation (ECMO) has been successfully used postoperatively to reverse the effects of severe pulmonary hypertension. Since 1984, ECMO has been required in 27 of the patients we treated with CDH. ⋯ Four were repaired through an abdominal approach, and two via thoracotomy; four required a Gortex patch closure. Postoperative bleeding was not a major problem in these heparinized patients. Four of these six patients survived, and follow-up of 2 months to 3 years shows no significant respiratory compromise.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Pulmonary hypertension in neonatal cystic lung disease: survival following lobectomy and ECMO in two cases.
Extracorporeal membrane oxygenation (ECMO) is an accepted form of therapy in the treatment of neonates with otherwise lethal persistent pulmonary hypertension related to meconium aspiration, congenital diaphragmatic hernia, and sepsis. This report concerns two neonates with congenital cystic lesions of the lung who developed severe pulmonary hypertension and were salvaged with lobectomy and ECMO. These cases present an additional group of patients in whom ECMO may be a life-saving measure.