Extracorporeal membrane oxygenation for the management of congenital diaphragmatic hernia-our experience in two neonates

Congenital diaphragmatic hernia (CDH) is characterized by a developmental defect in posterolateral aspect of the diaphragm leading to migration of abdominal viscera into the thorax, hypoplasia of lungs and pulmonary hypertension. Neonates present with respiratory failure within few hours after birth. Management includes endotracheal intubation, mechanical ventilation, gastric decompression and supportive treatment. Neonates with pulmonary hypoplasia and severe pulmonary hypertension also require inhaled nitric oxide and high frequency oscillatory ventilation (HFOV). Extracorporeal membrane oxygenation (ECMO) support is used for stabilization and surgical repair of CDH. We report our experience in two neonates with CDH. HFOV and ECMO support were used for surgical repair of the defect.