TY - JOUR
T1 - Longitudinal Analysis of Pulmonary Function in Survivors of Congenital Diaphragmatic Hernia
AU - Dao, Duy T.
AU - Hayden, Lystra P.
AU - Buchmiller, Terry L.
AU - Kharasch, Virginia S.
AU - Kamran, Ali
AU - Smithers, Charles J.
AU - Rice-Townsend, Samuel E.
AU - Zalieckas, Jill M.
AU - Becker, Ronald
AU - Morash, Donna
AU - Studley, Mollie
AU - Wilson, Jay M.
AU - Sheils, Catherine A.
N1 - Funding Information:
Funded by the National Institutes of Health (5T32HL007734 [to D.D.] and 5K23HL136851 [to L.H.]). The funders had no role in study design, data analysis, decision to publish, or preparation of the manuscript. The authors declare no financial conflict of interest.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - 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.
AB - 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.
KW - FEV
KW - FVC
KW - congenital diaphragmatic hernia
KW - linear mixed effects model
KW - pulmonary function test
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U2 - 10.1016/j.jpeds.2019.09.072
DO - 10.1016/j.jpeds.2019.09.072
M3 - Article
C2 - 31704056
AN - SCOPUS:85075379089
SN - 0022-3476
VL - 216
SP - 158-164.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -