RMS Wong, A Lee, KKY Wong, MSC Wong, YY Chee, K Jalal

Abstract

Congenital diaphragmatic hernia remains a challenge to physicians worldwide. Studies have shown that several antenatal and postnatal factors affect the survival outcome of congenital diaphragmatic hernia (CDH). We reviewed our patients with this condition from 2005 to 2016. The overall survival was 82.5%. High pre-operative oxygen index remains a significant risk factor for death. There was marked improvement in survival with the standard use of inhaled nitric oxide on patients with pulmonary hypertension since 2005. Patients with repair-operation performed within the first week of life also showed significantly higher survival. We also looked into the possible benefits of extracorporeal membrane oxygenation (ECMO) in CDH. Reviewing with the Extracorporeal Life Support Organization criteria, if ECMO is available, 2.5 more survivals may be anticipated compared with no ECMO. Technological advancement in management of CDH has shown promising survival results in the past years. While ECMO is more readily available nowadays, we may be able to save more babies with CDH.