Link: https://pubmed.ncbi.nlm.nih.gov/31704056-longitudinal-analysis-of-pulmonary-function-in-survivors-of-congenital-diaphragmatic-hernia/

J Pediatr
, 216, 158-164.e2 Jan 2020
Longitudinal Analysis of Pulmonary Function in Survivors of Congenital Diaphragmatic Hernia
Duy T Dao 1, Lystra P Hayden 2, Terry L Buchmiller 3, Virginia S Kharasch 4, Ali Kamran 3, Charles J Smithers 5, Samuel E Rice-Townsend 3, Jill M Zalieckas 3, Ronald Becker 6, Donna Morash 3, Mollie Studley 3, Jay M Wilson 7, Catherine A Sheils 8
Affiliations expand
PMID: 31704056 PMCID: PMC6917899 (available on 2021-01-01) DOI: 10.1016/j.jpeds.2019.09.072
Abstract
Objective: To analyze longitudinal trends of pulmonary function testing in patients with congenital diaphragmatic hernia (CDH) followed in our multidisciplinary clinic.

Study design: This was a retrospective cohort study of CDH patients born between 1991 and 2013. A linear mixed effects model was fitted to estimate the trends of percent predicted forced expiratory volume in 1 second (FEV1pp), percent predicted forced vital capacity (FVCpp), and FEV1/FVC over time.

Results: Of 268 patients with CDH who survived to discharge, 119 had at least 1 pulmonary function test study. The FEV1pp (P < .001), FVCpp (P = .017), and FEV1/FVC (P = .001) decreased with age. Compared with defect size A/B, those with defect size C/D had lower FEV1pp by an average of 11.5% (95% CI, 2.9%-20.1%; P = .010). A history of oxygen use at initial hospital discharge also correlated with decreased FEV1pp by an average of 8.0% (95% CI, 1.2%-15.0%; P = .023).

Conclusions: In a select cohort of CDH survivors, average pulmonary function declines with age relative to expected population normative values. Those with severe CDH represent a population at risk for worsening pulmonary function test measurements who may benefit from recognition and monitoring for complications.

Keywords: FEV(1); FVC; congenital diaphragmatic hernia; linear mixed effects model; pulmonary function test.

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