International survey on ECMO candidacy and exclusion criteria for infants with congenital diaphragmatic hernia

M Yang; B Yoder; M T Harting; J Daniel; C J Fernandes; B Gray; S H Gowda; J Ibrahim; K Lichtsinn; B Mahmood; A Makkar; F Miquel-Verges; P Thakkar; N Rintoul; R Rodriguez; B Thomas; R DiGeronimo; N Carr

doi:10.1177/02676591261452054

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International survey on ECMO candidacy and exclusion criteria for infants with congenital diaphragmatic hernia

Journal article

Peer reviewed

International survey on ECMO candidacy and exclusion criteria for infants with congenital diaphragmatic hernia

M Yang, B Yoder, M T Harting, J Daniel, C J Fernandes, B Gray, S H Gowda, J Ibrahim, K Lichtsinn, B Mahmood, …

Perfusion

09/01/2026

DOI: 10.1177/02676591261452054

PMID: 42681827

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Abstract

Introduction Severe congenital diaphragmatic hernia (CDH) is associated with significant morbidity and mortality. Pre/post-natal risk factors guide decisions on extracorporeal membrane oxygenation (ECMO) intervention. We aimed to describe variations in ECMO decision-making for neonatal CDH.Methods We distributed a practice-based survey (October 2023) to assess institutional ECMO guidelines for neonatal CDH. Respondents included neonatal/pediatric intensivists, surgeons, and ECMO coordinators. We used descriptive statistics for analysis.ResultsFormal CDH management guidelines were reported by 60 (77%) from 82 respondents across 12 countries. The most common exclusion criteria were prematurity (73%), low birthweight (72%), and aneuploidy (58%). Pre-existing neurological complications, single ventricle palliation heart disease, and genetics-related poor neurodevelopmental prognosis were the most cited exclusion criteria independent of CDH severity.Conclusion Significant practice variation exists in the exclusion criteria for ECMO in neonatal CDH. There remains an opportunity for a more unified approach regarding ECMO use in infants with severe CDH.

congenital diaphragmatic hernia

extracorporeal membrane oxygenation

practice variation

clinical decision-making

neonatal intensive care

Details

Title: Subtitle: International survey on ECMO candidacy and exclusion criteria for infants with congenital diaphragmatic hernia
Creators: M Yang - University of Utah
B Yoder - University of Utah
M T Harting - The University of Texas Health Science Center at Houston
J Daniel - Children's Mercy Hospital
C J Fernandes - Texas Children's Hospital
B Gray - Riley Hospital for Children
S H Gowda - Texas Children's Hospital
J Ibrahim - University of Pittsburgh Medical Center
K Lichtsinn - Seattle Children's Hospital
B Mahmood - University of Pittsburgh Medical Center
A Makkar - Southwestern University
F Miquel-Verges - Arkansas Children's Hospital
P Thakkar - University of Oklahoma Health Sciences Center
N Rintoul - Children's Hospital of Philadelphia
R Rodriguez - Atrium Health Wake Forest Baptist
B Thomas - University of Iowa Stead Family Children’s Hospital
R DiGeronimo - Seattle Children's Hospital
N Carr - Intermountain Healthcare
Resource Type: Journal article
Publication Details: Perfusion
DOI: 10.1177/02676591261452054
PMID: 42681827
NLM abbreviation: Perfusion
ISSN: 0267-6591
eISSN: 1477-111X
Publisher: Sage
Language: English
Electronic publication date: 09/01/2026
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9985224389902771

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