Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Children's Hospital Colorado, 13121 E 17th Ave, MS 8402, Aurora, CO, 80045.
Department of Pediatrics, Division of Neonatology, University of Pennsylvania Perelman School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.
Semin Perinatol. 2018 Mar;42(2):96-103. doi: 10.1053/j.semperi.2017.12.005. Epub 2018 Jan 12.
Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly which impairs normal pulmonary development leading to acute and chronic respiratory failure, pulmonary hypoplasia, pulmonary hypertension, and mortality. CDH is the most common non-cardiac indication for neonatal ECMO. Prenatal and postnatal predictors of CDH severity aid in patient selection. Centers vary in preferred mode of ECMO and timing of CDH repair. Survivors of severe CDH with ECMO are at risk for long-term sequelae including neurodevelopmental delays.
先天性膈疝 (CDH) 是一种严重的先天性畸形,它会损害正常的肺发育,导致急性和慢性呼吸衰竭、肺发育不全、肺动脉高压和死亡。CDH 是新生儿 ECMO 最常见的非心脏适应证。CDH 严重程度的产前和产后预测因素有助于患者选择。不同中心对 ECMO 的首选模式和 CDH 修复时机存在差异。接受 ECMO 治疗的严重 CDH 幸存者有发生长期后遗症的风险,包括神经发育迟缓。