Hög överlevnad hos nyfödda med kongenitalt diafragmabråck. 20 års uppföljning av patienter som
vårdats i Stockholm
Sammanfattning
Since 1990 the treatment of congenital diaphragmatic hernia (CDH) in Stockholm has been characterized by gentle ventilation, preoperative stabilization, ECMO according to conventional criteria and delayed surgery. A second run of ECMO was offered if necessary. During the 20-year period 1990–2009 194 patients with CDH were admitted. 184 of these were Swedish with Swedish identification number and were eligible for long-term follow-up. 85 % of the patients were discharged alive. Long-term survival after 1–20 years was 79 %. Survival to discharge among ECMO patients was 69 % and 56 % had survived after 1–20 years. 13 patients required a second ECMO run. 8 of these survived to discharge and 7 were long-term survivors. We conclude that both survival to discharge and long-term survival are excellent in an international comparison with the presented treatment strategy. To further improve results on a national basis in Sweden centralization of care is suggested.