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Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation
OBJECTIVE: Children with congenital diaphragmatic hernia (CDH) are at risk for pulmonary morbidity. Data on longitudinal evaluation of lung function in CDH are scarce. We hypothesized that CDH patients would have impaired lung function that worsens over time. We evaluated lung function and its deter...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771804/ https://www.ncbi.nlm.nih.gov/pubmed/31197981 http://dx.doi.org/10.1002/ppul.24375 |
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author | Toussaint‐Duyster, Leontien C. C. van der Cammen‐van Zijp, Monique H. M. Spoel, Marjolein Tiddens, Harm A. W. M. Tibboel, Dick Wijnen, Rene M. H. van Rosmalen, Joost IJsselstijn, Hanneke |
author_facet | Toussaint‐Duyster, Leontien C. C. van der Cammen‐van Zijp, Monique H. M. Spoel, Marjolein Tiddens, Harm A. W. M. Tibboel, Dick Wijnen, Rene M. H. van Rosmalen, Joost IJsselstijn, Hanneke |
author_sort | Toussaint‐Duyster, Leontien C. C. |
collection | PubMed |
description | OBJECTIVE: Children with congenital diaphragmatic hernia (CDH) are at risk for pulmonary morbidity. Data on longitudinal evaluation of lung function in CDH are scarce. We hypothesized that CDH patients would have impaired lung function that worsens over time. We evaluated lung function and its determinants at ages 8 and 12 years. METHODS: Dynamic and static lung volumes, and diffusion capacity were measured. Extracorporeal membrane oxygenation (ECMO) treatment, the standardized European neonatal treatment protocol, patch repair, duration of ventilation, type of initial mechanical ventilation, and nitric oxide treatment were entered as covariates in linear mixed models with standard deviation score (SDS) lung function parameters (FEV(1), FEF (25‐75), and K (CO)) as dependent variables. RESULTS: Seventy‐six children (27 ECMO‐treated) born between 1999 and 2009 performed 113 reliable lung function tests. Severity of airflow obstruction deteriorated significantly from age 8 to 12 years: estimated mean difference (95% confidence interval [CI]) SDS FEV(1) was −0.57 (−0.79 to −0.36) and SDS FEF(25‐75) was −0.63 (−0.89 to −0.37), both P < .001. Static lung volumes were within normal range and unchanged over time: estimated mean difference (95% CI) SDS TLC −0.27 (−0.58 to 0.04); P = .085. SDS K(CO) was below normal at 8 and 12 years and remained stable: −0.06 (−0.22 to 0.35); P = .648. These observations were irrespective of ECMO treatment. FEV(1) and FEF(25‐75) were negatively associated with duration of ventilation (P < .001). Baseline data were not related with TLC or K(CO.) CONCLUSIONS: CDH patients should be followed into adulthood as they are at risk for worsening airflow obstruction and decreased diffusion capacity at school age, irrespective of ECMO treatment. |
format | Online Article Text |
id | pubmed-6771804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67718042019-10-07 Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation Toussaint‐Duyster, Leontien C. C. van der Cammen‐van Zijp, Monique H. M. Spoel, Marjolein Tiddens, Harm A. W. M. Tibboel, Dick Wijnen, Rene M. H. van Rosmalen, Joost IJsselstijn, Hanneke Pediatr Pulmonol Original Articles OBJECTIVE: Children with congenital diaphragmatic hernia (CDH) are at risk for pulmonary morbidity. Data on longitudinal evaluation of lung function in CDH are scarce. We hypothesized that CDH patients would have impaired lung function that worsens over time. We evaluated lung function and its determinants at ages 8 and 12 years. METHODS: Dynamic and static lung volumes, and diffusion capacity were measured. Extracorporeal membrane oxygenation (ECMO) treatment, the standardized European neonatal treatment protocol, patch repair, duration of ventilation, type of initial mechanical ventilation, and nitric oxide treatment were entered as covariates in linear mixed models with standard deviation score (SDS) lung function parameters (FEV(1), FEF (25‐75), and K (CO)) as dependent variables. RESULTS: Seventy‐six children (27 ECMO‐treated) born between 1999 and 2009 performed 113 reliable lung function tests. Severity of airflow obstruction deteriorated significantly from age 8 to 12 years: estimated mean difference (95% confidence interval [CI]) SDS FEV(1) was −0.57 (−0.79 to −0.36) and SDS FEF(25‐75) was −0.63 (−0.89 to −0.37), both P < .001. Static lung volumes were within normal range and unchanged over time: estimated mean difference (95% CI) SDS TLC −0.27 (−0.58 to 0.04); P = .085. SDS K(CO) was below normal at 8 and 12 years and remained stable: −0.06 (−0.22 to 0.35); P = .648. These observations were irrespective of ECMO treatment. FEV(1) and FEF(25‐75) were negatively associated with duration of ventilation (P < .001). Baseline data were not related with TLC or K(CO.) CONCLUSIONS: CDH patients should be followed into adulthood as they are at risk for worsening airflow obstruction and decreased diffusion capacity at school age, irrespective of ECMO treatment. John Wiley and Sons Inc. 2019-06-13 2019-08 /pmc/articles/PMC6771804/ /pubmed/31197981 http://dx.doi.org/10.1002/ppul.24375 Text en © 2019 The Authors Pediatric Pulmonology Published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Toussaint‐Duyster, Leontien C. C. van der Cammen‐van Zijp, Monique H. M. Spoel, Marjolein Tiddens, Harm A. W. M. Tibboel, Dick Wijnen, Rene M. H. van Rosmalen, Joost IJsselstijn, Hanneke Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title | Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title_full | Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title_fullStr | Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title_full_unstemmed | Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title_short | Lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
title_sort | lung function in school‐aged congenital diaphragmatic hernia patients; a longitudinal evaluation |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771804/ https://www.ncbi.nlm.nih.gov/pubmed/31197981 http://dx.doi.org/10.1002/ppul.24375 |
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