{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:15:10Z","timestamp":1740136510112,"version":"3.37.3"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,19]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether congenital diaphragmatic hernia repair outcomes are better before or after decannulation in infants requiring extracorporeal membrane oxygenation (ECMO). A total of 884 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that infants with congenital diaphragmatic hernia requiring ECMO should undergo a trial of weaning and aim for post-decannulation repair, as this has been associated with improved survival, shorter ECMO duration and fewer bleeding complications. However, if weaning of ECMO is unsuccessful, the patient should ideally undergo early on-ECMO repair (within 72\u2009h of cannulation), which has been associated with improved survival, less bleeding, shorter ECMO duration and fewer circuit changes compared to late on-ECMO repair. Anticoagulation protocols including perioperative administration of aminocaproic acid or tranexamic acid, as well as close perioperative monitoring of coagulation parameters have been associated with reduced bleeding risk with on-ECMO repairs.<\/jats:p>","DOI":"10.1093\/icvts\/ivaa303","type":"journal-article","created":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T20:07:11Z","timestamp":1605470831000},"page":"632-637","source":"Crossref","is-referenced-by-count":4,"title":["Congenital diaphragmatic hernia repair in patients requiring extracorporeal membrane oxygenation: are outcomes better with repair on ECMO or after decannulation?"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-3226","authenticated-orcid":false,"given":"Zhao Kai","family":"Low","sequence":"first","affiliation":[{"name":"Department of Cardio-thoracic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia Su May","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardio-thoracic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1683-4654","authenticated-orcid":false,"given":"Masakazu","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Cardio-thoracic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kok Hooi","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Cardio-thoracic Surgery, KK Women\u2019s and Children\u2019s Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"2022030919173743300_ivaa303-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S1569-9293(03)00191-9","article-title":"Towards evidence-based medicine in cardiothoracic surgery: best BETS","volume":"2","author":"Dunning","year":"2003","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022030919173743300_ivaa303-B2","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.jpedsurg.2009.02.022","article-title":"Congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation: does timing of repair matter?","volume":"44","author":"Bryner","year":"2009","journal-title":"J Pediatr Surg"},{"key":"2022030919173743300_ivaa303-B3","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.jpedsurg.2009.08.011","article-title":"Early repair of congenital diaphragmatic hernia on extracorporeal 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supported by extracorporeal membrane oxygenation (ECMO)","volume":"50","author":"Partridge","year":"2015","journal-title":"J Pediatr Surg"},{"key":"2022030919173743300_ivaa303-B7","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00383-016-4002-2","article-title":"Outcomes of congenital diaphragmatic hernia repair on extracorporeal life support","volume":"33","author":"Golden","year":"2017","journal-title":"Pediatr Surg Int"},{"key":"2022030919173743300_ivaa303-B8","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jpedsurg.2017.10.056","article-title":"Comparison of early versus delayed strategies for repair of congenital diaphragmatic hernia on extracorporeal membrane oxygenation","volume":"53","author":"Robertson","year":"2018","journal-title":"J Pediatr Surg"},{"key":"2022030919173743300_ivaa303-B9","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.jpedsurg.2019.02.052","article-title":"Potential survival benefit with repair of congenital diaphragmatic hernia (CDH) after extracorporeal membrane oxygenation (ECMO) in select patients: study by ELSO CDH Interest Group","volume":"54","author":"Delaplain","year":"2019","journal-title":"J Pediatr Surg"},{"key":"2022030919173743300_ivaa303-B10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jpedsurg.2018.10.038","article-title":"Congenital diaphragmatic hernia repair in patients on extracorporeal membrane oxygenation: how early can we repair?","volume":"54","author":"Steen","year":"2019","journal-title":"J Pediatr Surg"}],"container-title":["Interactive CardioVascular and Thoracic 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