Abstract
Purpose
Long-term pulmonary outcomes of congenital diaphragmatic hernia (CDH) have demonstrated
airflow obstruction in later childhood. We examined pulmonary function data to assess
what factors predict lung function in the first three years of life in children with
CDH.
Methods
This was a retrospective study of patients treated for CDH who underwent infant pulmonary
function testing (IPFT) between 2006 and 2012. IPFT was performed using the raised
volume rapid thoracoabdominal compression technique and plethysmography.
Results
Twenty-nine neonates with CDH had IPFTs in the first 3 years of life. Their mean predicted survival using the CDH Study Group equation was
63% ± 4%. Fourteen infants (48%) required extracorporeal membrane oxygenation (ECMO). The
mean age at IPFT was 85.1 ± 5 weeks. Airflow obstruction was the most common abnormality, seen in 14 subjects. 12
subjects had air trapping, and 9 demonstrated restrictive disease. ECMO (p = 0.002), days on the ventilator (p = 0.028), and days on oxygen (p = 0.023) were associated with restrictive lung disease.
Conclusion
Despite following a group of patients with severe CDH, lung function revealed mild
deficits in the first three years of life. Clinical markers of increased severity
(ECMO, ventilator days, and prolonged oxygen use) are correlated with reduced lung
function.
Key words
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Article info
Publication history
Published online: February 13, 2014
Accepted:
January 27,
2014
Received:
January 12,
2014
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
