Diaphragmatic function in infants and children with congenital diaphragmatic hernia: a cross-sectional study

Abstract OBJECTIVES Few studies have evaluated long-term diaphragmatic function in congenital diaphragmatic hernia (CDH). The aim of our cross-sectional study was to assess diaphragmatic function in infants and young children with CDH after surgical repair. METHODS All the patients with CDH repair f...

Full description

Saved in:
Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2018-04, Vol.53 (4), p.740-747
Main Authors: Khirani, Sonia, Amaddeo, Alessandro, Khen-Dunlop, Naziha, Olmo Arroyo, Jorge, Lapillonne, Alexandre, Becquet, Odile, Kermorvant-Duchemin, Elsa, Beaudoin, Sylvie, Rousseau, Véronique, Delacourt, Christophe, Fauroux, Brigitte
Format: Article
Language:English
Subjects:
Child, Preschool
Cross-Sectional Studies
Diaphragm - physiopathology
Diaphragm - surgery
Female
Hernias, Diaphragmatic, Congenital - physiopathology
Hernias, Diaphragmatic, Congenital - surgery
Humans
Infant
Infant, Newborn
Male
Respiration
Respiratory Muscles - physiopathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract OBJECTIVES Few studies have evaluated long-term diaphragmatic function in congenital diaphragmatic hernia (CDH). The aim of our cross-sectional study was to assess diaphragmatic function in infants and young children with CDH after surgical repair. METHODS All the patients with CDH repair followed in our centre between February 2014 and January 2016 were enrolled. Patients with a postnatal diagnosis after 1 month of life were excluded. Breathing pattern and diaphragmatic function were assessed using esophageal and gastric (Pgas) pressure recording after surgery, or at 1 or 5 years of age. RESULTS Twenty-eight patients (24 left-sided CDH, 6 with diaphragmatic patch) were included. Twelve patients were assessed before hospital discharge (Y0), 6 around the age of 1 year (Y1) and 10 around the age of 5 years (Y5). Mean antenatal estimated pulmonary volume (VLA) was 42 ± 10% (n = 23). Diaphragmatic strength, assessed by transdiaphragmatic pressure during crying/sniff, was low at Y0 (47 ± 18 cmH2O, n = 12) and within normality at Y5 (81 ± 15 cmH2O, n = 7). Diaphragmatic dysfunction, assessed by Pgas during crying/sniff, was present at Y0 (−58 ± 22 cmH2O, n = 12) and Y1 (−53 ± 36 cmH2O, n = 5) and still present at Y5 (3 ± 9 cmH2O, n = 7) but to a lesser extent. The diaphragmatic tension time index (TTdi), which estimates diaphragmatic endurance, was high at Y0 (0.10 ± 0.04, n = 11) and within normality at Y5 (0.03 ± 0.01, n = 6). VLA correlated with neonatal TTdi (r = −0.961, P 
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezx391