Does extra-corporeal membrane oxygenation improve survival for severely unwell neonates with Congenital Diaphragmatic Hernia?

A neonate on the intensive care unit with an isolated congenital diaphragmatic hernia is failing on conventional ventilation. There are no exclusion criteria for extra-corporeal membrane oxygenation (ECMO). Should the neonate be transferred for ECMO?

Doherty and MacKinnon at St Mary’s Hospital, Manchester, UK, are questioning if we should be thinking of ECMO as a proven and effective therapy.

Are you aware of the total number of babies with Congenital Diaphragmatic Hernia that have received ECMO in trials? Would you be shocked to learn is was less than fifty? And what outcomes should we really be assessing?

Acknowledgement: Image from St Vincent’s Hospital, Sydney