Extracorporeal membrane oxygenation (ECMO) is a treatment that allows the lungs and heart to rest while a machine takes over their function. Babies born with congenital diaphragmatic hernia (CDH) may go on ECMO if they aren’t responding well to other efforts to stabilize them.
What determines if a CDH baby needs to go on ECMO?
We use a specific set of guidelines to indicate if a baby with CDH needs to go on ECMO. The most common indications for ECMO are pulmonary hypertension, heart failure, and need for respiratory support that could damage lungs.
How long is the “typical” ECMO run for babies with CDH?
The average time on ECMO for a CDH baby is two weeks, but can vary. Most babies with CDH who go on to ECMO do so the first day of life.
What are the possible complications from ECMO?
The most significant complication of ECMO is bleeding disorders — either clots or hemorrhage — which can cause the need for additional operations and neurologic complications.
What determines when a baby with CDH is ready to be weaned off ECMO?
The most important factors to consider when weaning a baby with CDH from ECMO include:
- Your baby’s clinical stability
- Fluid status
- Appearance of the lungs
- Presence of pulmonary hypertension
We will use the baby’s tolerance to care, echocardiogram images, blood work results, and chest x-ray to determine the timing of a trial off ECMO.
The CDH care team will increase the ventilator support and decrease the ECMO support, allowing the baby to take over more and more. If this transition is well-tolerated, the baby can be weaned off ECMO.