BMC Pediatr

. 2021 Mar 11;21(1):120. doi: 10.1186/s12887-021-02586-3. https://pubmed.ncbi.nlm.nih.gov/33706730/

Functional and structural evaluation in the lungs of children with repaired congenital diaphragmatic hernia

June-Young Koh ^1 2, Euiseok Jung ¹, Hyun Woo Goo ³, Seong-Chul Kim ⁴, Dae Yeon Kim ⁴, Jung-Man Namgoong ⁴, Byong Sop Lee ¹, Ki-Soo Kim ¹, Ellen Ai-Rhan Kim ⁵Affiliations expand

• PMID: 33706730
• PMCID: PMC7947149
• DOI: 10.1186/s12887-021-02586-3

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Abstract

Background: To evaluate the long-term functional and structural pulmonary development in children with repaired congenital diaphragmatic hernia (CDH) and to identify the associated perinatal-neonatal risk factors.

Methods: Children with repaired CDH through corrective surgery who were born at gestational age ≥ 35 weeks were included in this analysis. Those who were followed for at least 5 years were subjected to spirometry and chest computed tomography for evaluation of their functional and structural growth. Main bronchus diameters and lung volumes (total, left/right) were measured. According to total lung volume (TLV) relative to body surface area, children were grouped into TLV ≥ 50 group and TLV < 50 group and the associations with perinatal-neonatal factors were analyzed.

Results: Of the 28 children (mean age, 6.2 ± 0.2 years) with left-sided CDH, 7 (25%) had abnormal pulmonary function, of whom 6 (87%) showed restrictive patterns. All pulmonary functions except FEF25-75% were worse than those in matched healthy control group. Worse pulmonary function was significantly associated with small head and abdominal circumferences at birth. The mean TLV was 1339.1 ± 363.9 mL and LLV/TLV was 47.9 ± 2.5 mL. Children with abnormal pulmonary function were more likely to have smaller lung volumes. In multivariate analysis, abdominal circumference at birth was significantly associated with abnormal lung volume.

Conclusions: A quarter of children with repaired CDH showed abnormal pulmonary function. Small abdominal circumference at birth was associated with abnormal pulmonary function and lower TLV. .

Keywords: Computed tomography; Congenital diaphragmatic hernia; Pulmonary function tests; Risk factors.