Optimizing Congenital Diaphragmatic Hernia Repair on ECMO: Evaluating the Risk of Bleeding
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- Low birth weight, platelets <100K, elevated BUN, and older age at repair increase bleeding risk in on-ECMO CDH repair patients
- Bleeding complications during on-ECMO CDH repair correlate with longer ECMO duration, prolonged ventilation, and reduced survival
- Earlier CDH repair with platelet count >100K may reduce bleeding complications in ECMO-supported patients
- 11 of 46 patients (24%) experienced bleeding complications during on-ECMO diaphragmatic hernia repair in this single-center cohort
- Optimizing timing and platelet thresholds for CDH repair on ECMO may improve outcomes in this high-risk population
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What risk factors are associated with bleeding complications and patients on the on-eckmon congenital diaphragmatic herniar repair? I'm Alex Halpern, research fellow from Children's National, and this is an article that you should know. Smoke at all performed a single institution in retrospective analysis of all patients who underwent on-eckmonocidial repair between 2005 and 2023 to try and answer this question. They identified 46 patients. Eleven patients had bleeding complications. Low birth weight, platelet count less than 100, elevated BUN, and older age-ever pair were associated with bleeding. Patients who experienced the bleeding complication had more days on eckmon, more days on the ventilator, and a lower survival at discharge. So it seems like patients undergoing on-eckmonocidial repair may benefit from an earlier repair instead of their platelets greater than 100 to help prevent bleeding complications. Does this information change your practice? Let us know what you think in the comments below.