The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Axinia Corches

Axinia Corches

Treating Congenital Diaphragmatic Hernia with ECMO: First Successful Case in Romania

We present the first successful case of extracorporeal membrane oxygenation (ECMO) at „M.S. Curie” Emergency Clinical Hospital for Children, Newborn Intensive Care Unit: a term neonate with cardiorespiratory failure secondary to left sided congenital diaphragmatic hernia. The patient was placed on veno-venous ECMO at three days of life;
however, on the fourth day, due to unstable right ventricular function, conversion to veno-arterial ECMO was mandatory. At one week of life, the patient was operated on-site for diaphragmatic hernia without ECMO support and then reintroduced on ECMO immediately after the surgical procedure, being on ECMO support for a total of 8 days. Antithrombotic treatment was administered for significant occlusion of the right common carotid artery and right internal jugular vein (complication of the cannulation for ECMO) and also long term treatment for Persistent Pulmonary Hypertension was needed. The patient was discharged at the age of four months with moderate neurodevelopmental delay. The literature review indicates that neonatal ECMO procedure in Romania is still in its early stages. Despite this state, our current case proves that ECMO can be successfully performed with increased chances of survival for neonates with severe prognosis after failure of conventional therapy.

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Current Aspects of Clinical Genetic Diagnosis in Werdnig-Hoffman Spinal Muscular Atrophy

Type I Werdnig-Hoffman spinal muscular atrophy (SMA) is a progressive neuromuscular disease with recessive autosomal transmission characterized by muscular weakness and atrophy caused by degeneration of motor neurons in the spinal cord and in the brainstem nuclei.
In the early 1980s, Werdnig and Hoffman described a disorder with childhood onset that was characterized by progressive muscle weakness. In terms of histopathology, it showed loss of neurons in the previous horns of the spinal cord. (Katirji B, 2002).

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