Clinical outcomes of congenital diaphragmatic hernia without extracorporeal membrane oxygenation

Neonatal extracorporeal membrane oxygenation (ECMO) is not available in Hong Kong.

To document the survival of neonates with symptomatic congenital diaphragmatic hernia at birth, but without access to ECMO.

Twenty-two patients diagnosed to have CDH within a ten year period (1999-2009) at Prince of Wales Hospital were systematically reviewed. CDH patients who presented after the neonatal period were excluded.

There were 17 neonates with symptomatic CDH at birth and the overall survival, including infants with multiple anomalies, was 14/17 (82%). 6 of 17 (35%) infants met the ECMO criteria and the survival rate for these serious cases was 4/6 (67%).

Our results are comparable with centers which provide ECMO and suggest that there may be only marginal benefit for using ECMO to improve survival. A territory-wide registry for documenting risk factors and outcomes would be important, especially in light of improving neonatal intensive care and survival.