J Pediatr. 2019 Nov 5. pii: S0022-3476(19)31308-3. doi: 10.1016/j.jpeds.2019.09.072. [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/31704056
Longitudinal Analysis of Pulmonary Function in Survivors of Congenital Diaphragmatic Hernia.
Dao DT1, Hayden LP2, Buchmiller TL3, Kharasch VS4, Kamran A3, Smithers CJ5, Rice-Townsend SE3, Zalieckas JM3, Becker R6, Morash D3, Studley M3, Wilson JM7, Sheils CA8.
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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.
Copyright © 2019 Elsevier Inc. All rights reserved.
KEYWORDS:
FEV(1); FVC; congenital diaphragmatic hernia; linear mixed effects model; pulmonary function testPMID: 31704056 DOI: 10.1016/j.jpeds.2019.09.072
