Predictors of early lung function in patients with congenital diaphragmatic hernia.

[congenital diaphragmatic hernia]

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 .T his 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 .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 .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 .