Less is more: ECMO utilization and outcomes in congenital diaphragmatic hernia

jpedsurg.org

Infants with congenital diaphragmatic hernia (CDH) have varying degrees of pulmonary hypoplasia leading to cardiopulmonary derangements such as pulmonary hypertension. Extracorporeal membranous oxygenation (ECMO) can be necessary for survival in some patients. Our institution implemented a change in the NICU critical care management guideline for neonates with CDH in 2016. Indications for ECMO remained the same in the revised guideline. This study evaluated survival and surgical outcomes in CDH patients who underwent repair before and after this guideline change.

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Article · Aug 2025 · 1 min read

In brief

This study examines how a 2016 change in NICU critical care guidelines affected ECMO utilization and surgical outcomes in infants with congenital diaphragmatic hernia. The research compares survival rates and treatment approaches before and after implementation of the revised management protocol for CDH patients with pulmonary hypoplasia and cardiopulmonary complications.

CDH causes pulmonary hypoplasia and pulmonary hypertension requiring ECMO support in severe cases
NICU management guideline changes in 2016 maintained ECMO indications but altered critical care approach
Study compares CDH repair outcomes pre- and post-guideline implementation to assess survival impact
ECMO remains a key rescue therapy for cardiopulmonary failure in high-risk CDH neonates

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