Eur J Pediatr Surg

. 2023 Dec 13.

 doi: 10.1055/a-2228-6969. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/38092047/

The timing of surgery for congenital diaphragmatic hernia in infants, on or after weaning from extracorporeal membrane oxygenation: A meta-analysis

Minhua Lin ¹, Jiachi Liao ¹, Le Li ¹

Affiliations expand

• PMID: 38092047
• DOI: 10.1055/a-2228-6969

Abstract

Aims: We conducted a meta-analysis of trials to determine the optimal time to conduct surgery for congenital diaphragmatic hernia (CDH) in infants, on or after weaning from extracorporeal membrane oxygenation (ECMO).

Methods: We searched the PubMed, Embase, Scopus and Cochrane Library databases to identify relevant articles published prior to May 2023 in which surgery was performed to treat congenital diaphragmatic hernia in infants. Data were collected, and continuous data were represented by the mean difference (MD) and 95% confidence interval (CI). Dichotomous data were represented by the odds ratio (OR) and 95% Cl. Review Manager V.5.4 and Stata were used to synthesize results and to assess publication bias.

Results: The results showed that infants undergoing surgery after being weaned from ECMO had reduced mortality (OR, 2.40; 95% Cl, 1.23-4.69; P=0.01) and postoperative bleeding rates (OR, 16.20; 95% Cl, 5.73-45.76; P<0.00001) and reduced ECMO duration (MD, 3.47; 95% Cl, 1.89-5.05; P<0.0001) compared to those who underwent surgery while on ECMO. There was no statistically significant difference in hospital duration (MD, 5.48; 95% Cl, -8.66-19.62; P=0.45) or ventilator duration (MD, -1.93; 95% Cl, -8.55-4.68; P=0.57).

Conclusions: We recommend weaning patients with CDH from ECMO before performing surgery.

Thieme. All rights reserved.