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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
.
Diseases
Validation
Diseases presenting
"pulmonary function testing"
symptom
congenital diaphragmatic hernia
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