Conflict of interest: None.
Original Article: Neonatal Lung Disease
Lung function in young adults with congenital diaphragmatic hernia; a longitudinal evaluation†
Article first published online: 26 MAR 2012
Copyright © 2012 Wiley Periodicals, Inc.
Volume 48, Issue 2, pages 130–137, February 2013
How to Cite
Spoel, M., van der Cammen-van Zijp, M. H.M., Hop, W. C.J., Tibboel, D., de Jongste, J. C. and IJsselstijn, H. (2013), Lung function in young adults with congenital diaphragmatic hernia; a longitudinal evaluation. Pediatr. Pulmonol., 48: 130–137. doi: 10.1002/ppul.22557
- Issue published online: 15 JAN 2013
- Article first published online: 26 MAR 2012
- Manuscript Accepted: 27 FEB 2012
- Manuscript Revised: 27 JAN 2012
- Manuscript Received: 22 SEP 2011
- Fonds Nuts-Ohra and Swart-van Essen Foundation
- pediatric lung disease;
- mechanical ventilation;
- respiratory measurement;
- lung physiology
Survival rates of patients with congenital diaphragmatic hernia (CDH) have improved to up to 80%. Little is known about long-term consequences of the disease and its treatment. We evaluated lung function and respiratory symptoms longitudinally in a previously studied cohort of CDH patients and age-matched non-CDH patients who underwent similar neonatal intensive care treatment.
We tested 27 young adults [mean (SD) age: 26.8 years (2.9)] with CDH and 30 non-CDH patients. Dynamic and static lung volumes, midexpiratory flows, and diffusion capacity were expressed as mean (SD) standard deviation scores. Prevalence of respiratory symptoms was evaluated with the European Community Respiratory Health Survey.
All data are expressed as mean (SD). FEF25–75 in CDH patients had slightly deteriorated since childhood (CDH: −0.7 (1.4) vs. −1.6 (1.5), P < 0.001; non-CDH patients: 0.2 (1.4) vs. −0.3 (1.6), P = 0.038, ns). Diffusion capacity decreased in both groups (CDH: DLCOc 0.2 (1.1) vs. −1.5 (1.1), P <0.001; non-CDH: DLCOc 0.1 (0.4) vs. −1.1 (1.1), P < 0.001). Lung volumes were normal in both groups. The prevalence of asthma was higher than in the normal population (27.6% in patients and 30% in controls, P < 0.001).
Airflow obstruction and diffusion capacity deteriorated mildly from childhood into adulthood in survivors of CDH. The improved survival of patients with more severe forms of diaphragmatic hernia calls for long-term follow-up of lung function. Pediatr Pulmonol. 2013; 48:130–137. © 2012 Wiley Periodicals, Inc.