The Journal of Middle East and North Africa Sciences 2021; 7(07) http://www.jomenas.org 5               ! Reema Aslam • Maria Jamil • Aanal Patel • Safeera Khan California Institute of Behavioral Neurosciences and Psychology, 4751 Mangels Blvd, Fairfield, CA, 94534, USA neurocalcibnp@gmail.com " Congenital Diaphragmatic Hernia (CDH) is a rare birth defect in which the diaphragm fails to close during prenatal development, which causes the intestinal contents to herniate into the chest from the abdominal cavity causing lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for infants having CDH on whom the conventional ventilation strategies fail. Our systematic review aimed to evaluate the outcomes of Extracorporeal Membrane Oxygenation (ECMO) use on infants with Congenital Diaphragmatic Hernia (CDH). We used PubMed, Embase, Web of Science and Google Scholars databases for our data collection, and articles from 2010>2021 were analyzed and included as part of this research. We included studies in the English language conducted on human infants. We excluded studies conducted before 2010, studies on animals, languages other than English, or studies conducted on the adult population from our research. We identified a total of 3650 studies from the databases. After removing duplicates, screening titles, applying inclusion>exclusion criteria, and assessing the papers' quality, we were left with nine articles. Six out of these nine articles were retrospective cohort studies, and three were literature reviews. We extracted data manually from these studies. ECMO's role in managing CDH in infants is controversial as some studies show improvements in infants' survival rate. In contrast, other studies mention that the risks involved in ECMO use outweigh the benefits, and we should only use it in those infants who are severely affected. Due to inadequate data, we require additional research to determine whether the use of ECMO is favorable or should it be discouraged.     [Aslam, R., Jamil, M., Patel, A. & Khan, S. (2021). The Management of Congenital Diaphragmatic Hernia in Infants with Extracorporeal Membrane Oxygenation: A Systematic Review.         , 7(07), 5>11]. (P>ISSN 2412> 9763) > (e>ISSN 2412>8937). www.jomenas.org" # $%: Extracorporeal Membrane Oxygenation (ECMO), Extracorporeal Life Support, Congenital Diaphragmatic Hernia, Infants. &" %’ Congenital diaphragmatic hernia (CDH) is a congenital defect with a mortality rate ranging from 8% to 80% and occurs in one infant out of every 5000 births (Vaja et al., 2017). We can define congenital diaphragmatic hernia (CDH) as the failure to develop the diaphragm of newborns resulting from incomplete fusion of structures forming the diaphragm (McHoney, & Hammond, 2018). It leads to herniation of abdominal contents into the chest cavity causing impaired pulmonary development. High mortality in CDH is due to pulmonary hypertension, pulmonary hypoplasia, and other congenital anomalies (Grover et al., 2018). Neonates with CDH immediately after birth show signs of respiratory distress due to lung hypoplasia caused by the lungs' compression due to the herniated abdominal contents into the chest cavity (Bojanić et al. 2017). Advancements in technology have led to permissive hypercapnia, inhaled nitric oxide (iNO), high> frequency ventilation, and extracorporeal membrane oxygenation (ECMO) treatment of infants with CDH. The timing of surgical intervention has also changed from emergent perinatal surgery to delayed operation once the infant's condition improves (Hoffman et al., 2010). CDH is the most common noncardiac indication for neonatal ECMO (Grover et al., 2018). Infants with Persistent pulmonary hypertension of the newborn (PPHN) and Pulmonary hypoplasia (PH) that do not respond to medical management are stabilized with Extracorporeal Membrane Oxygenation (ECMO) (Golden et al., 2017). ECMO provides recovery from a reversible respiratory failure by maintaining cardiac and pulmonary functions (Peter et al., 2020). Delivery of infants with a prenatal diagnosis of CDH should be in tertiary centers where early ECMO is available (Grover et al., 2018). According to the Extracorporeal Life Support Organization (ELSO) Registry's report, about 250>300 infants with CDH per year develop respiratory failure and receive ECMO (Peter et al., 2020). Extracorporeal life support