Abstract
Four critical cases of congenital diaphragmatic hernia (CDH) were treated with extracorporeal membrane oxygenation (ECMO). The indications, complications, and results of the use of ECMO, and the efficacy of respiratory management with high frequency oscillation (HFO) and delayed surgical repair of CDH are presented. One case was placed on ECMO for persistent fetal circulation (PFC), and other three cases were plased on ECMO for another complications such as elevated PaCO2, obstruction of the airway tract and circulatory disturbance in addition to PFC. All cases had complications that were hemorrhage related to systemic heparinization. There were endobronchial bleeding in three cases, gastric bleeding in one case and thoracic cavity bleeding in one case. One case died due to pulmonary bleeding ten days after weaning from ECMO. Other three cases survived and well grow thereafter. We tried respiratory management with HFO in three cases and delayed surgical repair of CDH in two cases before the use of ECMO, but these therapeutic methods were ineffective for them. These results show that ECMO is the effective method in the management of critical patients with CDH.
