Left ventricular cardiac output is a reliable predictor of extracorporeal life support in neonates with congenital diaphragmatic hernia

Objective Congenital diaphragmatic hernia (CDH) is a treatable condition but despite optimal management, some patients require extracorporeal life support (ECLS). This study evaluates the association of left ventricular (LV) cardiac output and the need for ECLS. Study design Single center, retrospective chart review from 1/1/2012 through 7/1/2018. Twenty-seven patients met criteria for evaluation with six patients (22%) requiring ECLS. Echocardiography was used to assess ventricular function. Results There was a statistically significant decrease in LV cardiac index of 1.33 L/min/m(2) vs 1.80 L/min/m(2) (p = 0.04) for patients requiring ECLS and non-ECLS, respectively. There was no difference between the 2 groups with regards to vasoactive medication use, surfactant use, iNO use, severity of pulmonary hypertension, or right ventricular (RV) function. Conclusion In newborns with CDH, decreased LV cardiac output is more strongly associated with need for ECLS than severity of pulmonary hypertension or RV dysfunction.