Extracorporeal membrane oxygenation in newborns with congenital diaphragmatic hernia: a review

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Abstract

Congenital diaphragmatic hernia (CDH) is a congenital malformation caused by a defect in the diaphragm and herniation of abdominal organs into the chest, requiring emergency surgical repair in the neonatal period. This review summarizes and analyzes data from international and national studies on the use of extracorporeal membrane oxygenation (ECMO) in newborns with CDH. We analyzed 153 publications from the PubMed, Cochrane, Springer, Clinical Key, and RSCI databases published between 2014 and 2025. Search keywords included ECMO, neonates, congenital diaphragmatic hernia, pulmonary hypertension, and mechanical ventilation. Only meta-analyses and randomized trials were included. Fifty articles on postnatal intensive care and ECMO use in infants with CDH were reviewed. Based on recent publications, this review provides an overview of ECMO techniques in newborns with CDH, including indications and contraindications, initial parameters, complications, methods for assessing efficacy, and weaning from ECMO. ECMO is a life-saving strategy that should be considered in children with CDH who do not respond to standard therapies; however, given the high risk of adverse effects and complications, the decision to use ECMO must be made on a case-by-case basis, guided by a personalized approach.

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About the authors

Ildar M. Ziganshin

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Author for correspondence.
Email: ildar.w@mail.ru
ORCID iD: 0000-0003-3462-3209
SPIN-code: 9939-6264
Russian Federation, Moscow

Artem A. Burov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: a_burov@oparina4.ru
ORCID iD: 0000-0001-7374-9803
SPIN-code: 8099-2934

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Mikhail V. Ketskalo

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: m_ketskalo@oparina4.ru
ORCID iD: 0000-0001-6569-2106
SPIN-code: 2352-1490

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Ivan I. Afukov

G.N. Speransky Children's City Clinical Hospital No. 9; Pirogov Russian National Research Medical University

Email: afukovdoc@yandex.ru
ORCID iD: 0000-0001-9850-6779
SPIN-code: 4284-4702

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Moscow; Moscow

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2. Fig. 1. Flowchart of source selection.

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3. Fig. 2. Classification of veno-arterial extracorporeal membrane oxygenation.

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4. Fig. 3. Weaning from extracorporeal membrane oxygenation [30].

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