Tang Wenfeng,He Qiuming,Zhong Wei,et al.Treatment of abdominal compartment syndrome with extracorporeal membrane oxygenation support during neonatal diaphragmatic hernia surgery: one case report with a literature review[J].Journal of Clinical Pediatric Surgery,,22():1082-1085.[doi:10.3760/cma.j.cn101785-202203064-015]
Treatment of abdominal compartment syndrome with extracorporeal membrane oxygenation support during neonatal diaphragmatic hernia surgery: one case report with a literature review
- Keywords:
- Congenital Diaphragmatic Hernia; Extracorporeal Membrane Oxygenation; Surgical Procedures; Operative; Child
- Abstract:
- Objective To summarize the experiences of diagnosing and treating abdominal compartment syndrome (ACS) after patch repairing of neonatal congenital diaphragmatic hernia (CDH) under extracorporeal membrane oxygenation (ECMO). Methods Retrospective reviews were conducted for the clinical data of ACS neonates due to CDH undergoing patch repairing under ECMO.Management and surgical procedure of ACS were systematically summarized.The databases of PubMed,Web of Science,Wanfang,China Academic Journals (CAJ) and China National Knowledge Infrastructure (CNKI) were searched with such keywords as "congenital diaphragmatic hernia","extracorporeal membrane oxygenation" and "abdominal compartment syndrome".Duplicate literatures were excluded and managements of ACS after patch repairing of neonatal CDH under ECMO summarized.Results One fetus with left-side CDH ultrasonically detected in second trimester was diagnosed as severe pulmonary hypoplasia.He was transferred immediately into our unit after a delivery by cesarean section at 39+6 weeks.ECMO support was provided after 19-hour mechanical ventilation and laparotomy patch repair of CDH was performed at 2 days post-birth.ACS was detected and treated with decompressive laparotomy (DL) at 4 days after repairing CDH.And a wound protector was utilized for keeping abdominal open during DL.ECMO was withdrawn at Day 3 and abdominal closure occurred at Day 5 post-DL.He was discharged at Day 38 post-birth.No recurrence occurred during a follow-up period of 4 months.A total of 16 English literature reports were reviewed.Four reports described 6 cases of CDH with postoperative ACS and 4 of them underwent DL.While another 12 reports examined 47 cases ACS under ECMO support and 37 of them underwent DL.Conclusions DL is effective for ACS during patch repair of neonatal CDH under ECMO.And wound protector is recommended for DL in neonates.
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Memo
收稿日期:2022-5-21。
基金项目:广东省基础与应用基础研究基金(2020A151501318);广州市科技创新发展专项资金项目(202102080511)
通讯作者:何秋明,Email:qiuminghe@foxmail.com