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Thoracoscopic vs open repair of congenital diaphragmatic hernia after extracorporeal membrane oxygenation: a comparison of intra-operative data.
Budzanowski, Annita; Loukogeorgakis, Stavros; Mullassery, Dhanya; Blackburn, Simon; Curry, Joe; Ioannou, Ioannis; Ali, Usman; Cross, Kate; Giuliani, Stefano; De Coppi, Paolo.
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  • Budzanowski A; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • Loukogeorgakis S; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • Mullassery D; Zayed Centre for Research, UCL Institute of Child Health London, 30 Guilford Street, London, WC1N 1EH, UK.
  • Blackburn S; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • Curry J; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • Ioannou I; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • Ali U; Anaesthesia Department, Great Ormond Street Hospital for Children, London, UK.
  • Cross K; Anaesthesia Department, Great Ormond Street Hospital for Children, London, UK.
  • Giuliani S; Great Ormond Street Hospital for Children, SNAPS, London, UK.
  • De Coppi P; Great Ormond Street Hospital for Children, SNAPS, London, UK.
Pediatr Surg Int ; 39(1): 82, 2023 Jan 16.
Article en En | MEDLINE | ID: mdl-36645513
PURPOSE: ECMO is an escalation treatment for hypoxic respiratory failure in patients with CDH. Open repair has been advocated after ECMO indicating that physiological changes associated to thoracoscopic repair were not well tolerated. METHODS: We have performed a retrospective review of all patients who underwent ECMO prior CDH repair over a 7 year period (2015-2021). Outcome measures were intra-operative Ph, PCO2, PO2 and FiO2 at 30 min, 1 h 30 min, and 2 h 30 min of surgery, operative time and recurrence rate. Data are shown in median (range). RESULTS: Eleven patients required ECMO prior CDH repair. Six of eleven (55%) were done thoracoscopically (Group A) and five of eleven (45%) via laparotomy (Group B). Two of six (33%) patients (Group A) were converted to a laparotomy, one of six (16%) patient developed a recurrence, and there was no recurrence in Group B. Two of five (40%) patients died within the first 60 days of life, whilst there was no death in Group A. Intra-operative values are shown below. CONCLUSION: Whilst this is a preliminary report of a limited number of patients, there is no obvious difference of intra-operative blood gas parameters during surgical repair in patients after ECMO. Thoracoscopic CDH repair may be considered in patients after ECMO.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Hernias Diafragmáticas Congénitas Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Hernias Diafragmáticas Congénitas Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article Pais de publicación: Alemania