Research: Long term outcomes in CDH: Cardiopulmonary outcomes and health related quality of life

J Pediatr Surg

. 2022 Apr 1;S0022-3468(22)00251-2. doi: 10.1016/j.jpedsurg.2022.03.020. Online ahead of print.

Long term outcomes in CDH: Cardiopulmonary outcomes and health related quality of life

Leonie Lewis 1Ian Sinha 2Sok-Leng Kang 3Joyce Lim 3Paul D Losty 4Affiliations expand


Background: With improvements in clinical management and an increase in CDH survivorship there is a crucial need for better understanding of long-term health outcomes in CDH.

Aim: To investigate the prevalence of cardiopulmonary health morbidity and health related quality of life (HRQoL) in CDH survivors.

Methods: We included all studies (n = 65) investigating long-term cardiopulmonary outcomes in CDH patients more than 2 years published in the last 30 years. The Newcastle-Ottawa Scale and the CASP checklist for cohort studies were utilized to assess study quality. Results were reported descriptively and collated by age group where possible.

Results: The incidence of pulmonary hypertension was highly variable (4.5-38%), though rates (%) appeared to diminish after 5 years of age. Lung function indices and radiological outcomes were frequently abnormal, and Health Related Quality of Life (HRQoL) reduced also. Long term diseases notably emphysema and COPD are not yet fully described in the contemporary literature.

Conclusion: This study underscores cardiopulmonary health morbidity and a reduced HRQoL among CDH survivors. Where not already available dedicated multidisciplinary follow-up clinics should be established to support these vulnerable patients transition safely into adulthood. Future research is therefore needed to investigate the risk factors for cardiopulmonary ill health and morbidity in CDH survivors.

Keywords: Cardiopulmonary; Congenital diaphragmatic hernia: Outcomes; Health-related quality of life.

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