25% of kids with repair of congenital diaphragmatic hernia can have abnormal pulmonary function: Study

The study is published in the BMC Pediatrics.

June-Young Koh and colleagues from the Departments of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea and Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea carried out this study to evaluate the long-term functional and structural pulmonary development in children with repaired congenital diaphragmatic hernia (CDH) and to identify the associated perinatal-neonatal risk factors.

Children with repaired congenital diaphragmatic hernia through corrective surgery who were born at gestational age ≥ 35 weeks were included in this analysis. Those who were followed for at least 5 years were subjected to spirometry and chest computed tomography for evaluation of their functional and structural growth.

Main bronchus diameters and lung volumes (total, left/right) were measured. According to total lung volume (TLV) relative to body surface area, children were grouped into TLV ≥ 50 group and TLV < 50 group and the associations with perinatal-neonatal factors were analyzed.

The findings revealed-

a. Of the 28 children (mean age, 6.2 ± 0.2 years) with left-sided CDH, 7 (25%) had abnormal pulmonary function, of whom 6 (87%) showed restrictive patterns.

b. All pulmonary functions except FEF25–75% were worse than those in matched healthy control group.

c. Worse pulmonary function was significantly associated with small head and abdominal circumferences at birth.

d. The mean TLV was 1339.1 ± 363.9 mL and LLV/TLV was 47.9 ± 2.5 mL.

e. Children with abnormal pulmonary function were more likely to have smaller lung volumes.

f. In multivariate analysis, abdominal circumference at birth was significantly associated with abnormal lung volume.

Hence, the authors concluded that "A quarter of children with repaired CDH showed abnormal pulmonary function. Small abdominal circumference at birth was associated with abnormal pulmonary function and lower TLV."