Enrico Danzer, Sabrina J. Flohr, Holly L. Hedrick, Geoffrey L. Bird, Jonathan M. Chen, Natalie E. Rintoul
Children’s Hospital of Philadelphia.
United States
Journal of ExtraCorporeal Technology
J Extra Corpor Technol 2025; 57: 168-170
DOI: 10.1051/ject/2025019
Abstract
Repeat extracorporeal membrane oxygenation (ECMO) is rare in children with congenital diaphragmatic hernia (CDH). Improving our understanding of the potential survival benefits, complications, and surgical challenges associated with this procedure is essential for enhancing decision-making regarding multicourse ECMO in CDH. We report the case of a now 3-year-old girl who required cannulation through median sternotomy 5 months after her initial neonatal ECMO treatment via cervical venoarterial cannulation. This second run of ECMO was performed due to an acute exacerbation of pulmonary hypertension caused by urosepsis. This case illustrates that repeat ECMO should be considered for selected CDH patients when a reversible cause for clinical deterioration is identified. We also emphasize the importance of interdisciplinary decision-making, considering alternative cannulation methods, and providing appropriate family counseling. It is crucial to balance the potential survival benefits of repeat ECMO against the increased risks of morbidity.
Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Class I. Pulmonary Hypertension Associated with Infection
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes