Open AccessTreating Congenital Diaphragmatic Hernia with ECMO: First Successful Case in Romania
Author(s) -
Alina Elena Gaiduchevici,
Carmina L. Georgescu,
Carmen Mariana HERISEANU,
Ana Mihaela Bizubac,
Cristina Filip,
Irina MARGARINT,
Ion CERNEA,
Cătălin Cîrstoveanu
Publication year - 2021
Publication title -
modern medicine
Language(s) - English
Resource type - Journals
eISSN - 2360-2473
pISSN - 1223-0472
DOI - 10.31689/rmm.2021.28.3.339
Subject(s) - medicine , congenital diaphragmatic hernia , extracorporeal membrane oxygenation , diaphragmatic hernia , surgery , intensive care unit , diaphragmatic breathing , hernia , intensive care medicine , fetus , pregnancy , genetics , alternative medicine , biology , pathology
We present the first successful case of extracorporeal membrane oxygenation (ECMO) at „M.S. Curie” Emergency Clinical Hospital for Children, Newborn Intensive Care Unit: a term neonate with cardiorespiratory failure secondary to left sided congenital diaphragmatic hernia. The patient was placed on veno-venous ECMO at three days of life; however, on the fourth day, due to unstable right ventricular function, conversion to veno-arterial ECMO was mandatory. At one week of life, the patient was operated on-site for diaphragmatic hernia without ECMO support and then reintroduced on ECMO immediately after the surgical procedure, being on ECMO support for a total of 8 days. Antithrombotic treatment was administered for significant occlusion of the right common carotid artery and right internal jugular vein (complication of the cannulation for ECMO) and also long term treatment for Persistent Pulmonary Hypertension was needed. The patient was discharged at the age of four months with moderate neurodevelopmental delay. The literature review indicates that neonatal ECMO procedure in Romania is still in its early stages. Despite this state, our current case proves that ECMO can be successfully performed with increased chances of survival for neonates with severe prognosis after failure of conventional therapy.