Extracorporale Membranoxygenierung (ECMO) bei der Behandlung von angeborenen Zwerchfellhernien

  • H. Wirth
  • W. Brands
  • W. Kachel
  • K.-L. Waag
Conference paper
Part of the Langenbecks Archiv für Chirurgie book series (DTGESCHIR, volume 1993)

Zusammenfassung

ECMO bietet die Möglichkeit, bei Zwerchfellhernien (CDH) die Überlebenschancen trotz Lungenhypoplasie und persistierendem fetalen Kreislauf zu verbessern. Wir versuchen den operativen Zwerchfellverschluß bis zur möglichen Stabilisierung des Patienten (Honeymoonphase) aufzuschieben. Dieses sog. Late Operation Protocol wurde inzwischen modifiziert. Bei instabilen Neugeborenen legen wir primär ECMO zur Oxygenierung an, und führen dann ggf. die Operation unter ECMO durch. Dadurch haben auch „Non-Responder“eine verbesserte Überlebenschance, da es keinerlei Kriterien zur prognostischen Beurteilung der Lungenreifung bei CDH-Patienten gibt.

Schlüsselwörter

Extracorporale Membranoxygenierung (ECMO) Angeborene Zwerchfellhernie 

Extraxorporeal Membrane Oxygenation in the Treatment of Congenital Diaphragmatic Hernias

Summary

ECMO may improve survival in CDH-patients, despite pulmonary hypoplasia and persistent fetal circulation. ECMO additionally enables us to postpone the surgical repair of the diaphragmatic hernia or defect until stabilization of the newborn (honeymoon-period). Meanwhile, the first Late Operation Protocol is modified. Without honeymoon-period we should do ECMO-treatment and operation during ECMO. The clinical results showed no difference in survival rate, and there is no prognostic parameter for the development of the hypoplastic lung. Surgical repair is possible during ECMO-treatment, so the most critical group of CDH-babies have a little chance for survival.

Key words

Extracorporeal Membrane Oxygenation (ECMO) Congenital diaphragmatic hernias 

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Literatur

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Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • H. Wirth
    • 1
  • W. Brands
    • 1
  • W. Kachel
    • 1
  • K.-L. Waag
    • 1
  1. 1.Kinderchirurgische Universitätsklinik MannheimMannheimDeutschland

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