HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Sophie M. Jaillard Alain J. Wurtz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jaillard, S. M. Articles by Storme, L. Search for Related Content PubMed PubMed Citation Articles by Jaillard, S. M. Articles by Storme, L. Related Collections Diaphragm

Ann Thorac Surg 2003;75:250-256
© 2003 The Society of Thoracic Surgeons

---

Original article: general thoracic

Outcome at 2 years of infants with congenital diaphragmatic hernia: a population-based study

^a Department of Thoracic Surgery, University Hospital of Lille, Lille, France
^b Department of Neonatology, University Hospital of Lille, Lille, France

Accepted for publication August 8, 2002.

* Address reprint requests to Dr Jaillard, Clinique Chirurgicale, Hôpital Calmette, Centre Hôpitalier Régional et Universitaire de Lille, 59037 Lille, France.
e-mail: sjaillard{at}chru-lille.fr

BACKGROUND: Management of neonates with congenital diaphragmatic hernia (CDH) has undergone many changes associated with increased survival of high-risk CDH. However, little is known about the long-term outcome of CDH infants.

METHODS: Follow-up was performed in 85 newborn infants with CDH admitted in our neonatal intensive care unit between January 1991 and December 1998. Early (< 2 months) and late mortality ( 2 months), and respiratory, nutritional, musculoskeletal, and neurosensory outcome at 2 years were recorded.

RESULTS: Surgical repair was performed in 59 infants (69%) at a median postnatal age of 124 (range, 38 to 246) hours. Extracorporeal membrane oxygenation was used in 26 (30%) newborn infants. Survival at 2 years was 51 of 85 (60%) (early death, 28/85 [33%]; late death, 6/85 [7%]). Late deaths occurred because of persistent pulmonary hypertension or iatrogenic complications. Twelve of 51 (24%) newborn infants were oxygen dependant at the postnatal age of 28 days, and 1 of 51 (1.9%) was still oxygen dependant at 2 years. Growth failure was noted in 9 of 51 (18%), mainly related to severe gastro-esophageal reflux and oral aversion. Scoliosis was diagnosed in 2 infants. Neurologic examination at 2 years was normal in 45 of 51 (88%). Cerebral palsy and developmental delay were observed in 2 and 4 infants, respectively. Four infants (8%) experienced associated problems. Respiratory, nutritional, and musculoskeletal morbidity was higher in infants treated by extracorporeal membrane oxygenation (p < 0.05).

CONCLUSIONS: CDH infants are at risk for adverse nutritional and respiratory outcome. Despite severe respiratory failure at birth, prolonged oxygen therapy above 2 years of age is uncommon. Conversely, failure to thrive related at least in part to gastroesophageal reflux and oral dysfunction remains the major problem at 2 years of age. However, both nutritional and respiratory problems tend to improve with age.

This article has been cited by other articles:

				Section on Surgery and the Committee on Fetus and Postdischarge Follow-up of Infants With Congenital Diaphragmatic Hernia Pediatrics, March 1, 2008; 121(3): 627 - 632. [Abstract] [Full Text] [PDF]

				J. Colvin, C. Bower, J. E. Dickinson, and J. Sokol Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study in Western Australia Pediatrics, September 1, 2005; 116(3): e356 - e363. [Abstract] [Full Text] [PDF]

				I M Balfour-Lynn, R A Primhak, and B N J Shaw Home oxygen for children: who, how and when? Thorax, January 1, 2005; 60(1): 76 - 81. [Abstract] [Full Text] [PDF]