J Pediatr
. 2026 Mar 13:293:115062.
doi: 10.1016/j.jpeds.2026.115062. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/41831781/
Effects of Extracorporeal Life Support Volume on Neonatal Mortality in Congenital Diaphragmatic Hernia: A Retrospective Cohort Study
Yigit S Guner 1, Alice Martino 2, Andreina Giron 3, Zoe Flyer 4, Karna Murthy 5, Matteo Di Nardo 6, John Schomberg 4, Theresa R Grover 7, J D Hammond 8, Peter T Yu 1, Laura F Goodman 1, Sharada H Gowda 9, Matthew T Harting 10, Tim Jancelewicz 11, Danh V Nguyen 12
Affiliations Expand
- PMID: 41831781
- DOI: 10.1016/j.jpeds.2026.115062
Abstract
We conducted a retrospective cohort study of 29 499 neonatal cases requiring extracorporeal life support (ECLS) at 237 centers from 2000 to 2023; there were 6747 infants with congenital diaphragmatic hernia (CDH) and 22 752 without CDH. Infants with CDH treated at ECLS centers with low total neonatal volumes (<28.5 total cases) had increased odds of inpatient mortality compared with those at high-volume centers (> 140 total cases, adjusted odds ratio [aOR]: 1.9; 95% confidence interval [CI]: 1.2-2.9). Similarly, centers with low non-CDH ECLS volumes were associated with higher odds of mortality among infants with CDH (aOR: 1.7; 95% CI: 1.1-2.5). Combined analysis of neonates with and without CDH also showed that low-volume centers were associated with higher odds of mortality compared with high-volume centers (aOR: 1.6; 95% CI: 1.3-2.0). These findings underscore the importance of procedural experience and support further investigation into the potential best practices adopted by high-volume centers.
Keywords: CDH; ECLS; ECMO; quality.
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