Multidisciplinary long-term follow-up of congenital diaphragmatic hernia: A growing trend

Tracy, Sarah A.; Chen, Catherine

doi:10.1016/j.siny.2014.09.001

Cited by 31 publications

(18 citation statements)

References 64 publications

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“…The 24‐hr mortality is 21–31% (Aly, Bianco‐Batlles, Mohamed, & Hammad, ; Balayla & Abenhaim, ), whereas the 1‐year mortality can be as high as 46% (Balayla & Abenhaim, ). In recent years, prenatal diagnosis and advanced neonatal care have decreased mortality; however, survivors face complex morbidities that may require long‐term medical support (Crankson, Al Jadaan, Namshan, Al‐Rabeeah, & Oda, ; Keijzer & Puri, ; Tracy & Chen, ).…”

Section: Introductionmentioning

confidence: 99%

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes

Ramakrishnan

Salemi

Stuart

et al. 2018

Birth Defects Research

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Section: Introductionmentioning

confidence: 99%

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes

Ramakrishnan

Salemi

Stuart

et al. 2018

Birth Defects Research

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“…Once the diaphragm is surgically repaired, lung morbidities are considered to be the main determinant for postnatal outcome, resulting in an overall survival rate up to 84% [5]. With the improvement in neonatal care of children with CDH, other factors than pulmonary hypoplasia and PAH impact on the prognosis like nutrition and infections [6, 7]. It is recognized that following the initial neonatal period, recurrent respiratory infections are frequently reported complications and are responsible for most hospital readmissions [7].…”

Section: Introductionmentioning

confidence: 99%

“…With the improvement in neonatal care of children with CDH, other factors than pulmonary hypoplasia and PAH impact on the prognosis like nutrition and infections [6, 7]. It is recognized that following the initial neonatal period, recurrent respiratory infections are frequently reported complications and are responsible for most hospital readmissions [7]. However, there are very few data concerning sepsis and healthcare-associated infection (HCAI) in this population and its impact on prognosis.…”

Section: Introductionmentioning

confidence: 99%

Sepsis risk factors in infants with congenital diaphragmatic hernia

Levy

Saché

Mokhtari³

et al. 2017

Ann. Intensive Care

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BackgroundCongenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown.MethodsThis prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH.Main resultsDuring their ICU stay, 28 patients (45%) developed 38 sepsis episodes. Ventilator-associated pneumonia (VAP: 23/38; 31.9 VAP per 1000 days of mechanical ventilation) and central line-associated blood stream infections (CLABSI: 5/38; 5.5 per 1000 line days) were the most frequently encountered infections. Multivariate analysis showed that gestational age at birth and intra-thoracic position of liver were significantly associated with the occurrence of sepsis. Infected patients had longer duration of mechanical and noninvasive ventilation (16.2 and 5.8 days, respectively), longer delay to first feeding (1.2 days) and a longer length of stay in ICU (23 days), but there was no difference in mortality.ConclusionsHealthcare-associated infections, and more specifically VAP, are the main infective threat in children with CDH. Sepsis has a significant impact on the duration of ventilator support and ICU length of stay but does not impact mortality. Low gestational age and intra-thoracic localization of the liver are two independent risk factors associated with sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0254-9) contains supplementary material, which is available to authorized users.

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“…Fetoscopic endoluminal tracheal occlusion (FETO) is being studied, with the aim to reduce mortality and morbidity 3 . Among survivors, pulmonary sequelae, gastrointestinal disorders, neurodevelopmental problems, musculoskeletal deformities, and CDH recurrence are frequently reported, especially in the first 3 years of life and these morbidities warrant the need for long‐term follow‐up programs 2,4 . Pulmonary morbidity, such as chronic lung disease (CLD), recurrent infections, and persistent pulmonary hypertension are present in 30%‐50% of the CDH survivors 2,5‐7 …”

Section: Introductionmentioning

confidence: 99%

“…3 years of life and these morbidities warrant the need for long-term follow-up programs. 2,4 Pulmonary morbidity, such as chronic lung disease (CLD), recurrent infections, and persistent pulmonary hypertension are present in 30%-50% of the CDH survivors. 2,[5][6][7] A prospective clinical follow-up program for CDH survivors at the age of 1 year was started in 2007 at the University Hospital of Leuven, a tertiary neonatal and pediatric referral center.…”

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confidence: 99%

Chest CT scoring for evaluation of lung sequelae in congenital diaphragmatic hernia survivors

Beel

Aukland

Boon

et al. 2020

Pediatric Pulmonology

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Objectives Data on long‐term structural lung abnormalities in survivors of congenital diaphragmatic hernia (CDH) is scarce. The purpose of this study was to develop a chest computed tomography (CT) score to assess the structural lung sequelae in CDH survivors and to study the correlation between the CT scoring and clinical parameters in the neonatal period and at 1 year of follow‐up. Methods A prospective, clinical follow‐up program is organised for CDH survivors at the University Hospital of Leuven including a chest CT at the age of 1 year. The CT scoring used and evaluated, named CDH‐CT score, was adapted from the revised Aukland score for chronic lung disease of prematurity. Results Thirty‐five patients were included. All CT scans showed some pulmonary abnormalities, ranging from very mild to severe. The mean total CT score was 16 (IQR: 9‐23), with the greatest contribution from the subscores for decreased attenuation (5; IQR: 2‐8), subpleural linear and triangular opacities (4; IQR: 3‐5), and atelectasis/consolidation (2; IQR: 1‐3). Interobserver and intraobserver agreement was very good for the total score (ICC coefficient > 0.9). Total CT score correlated with number of neonatal days ventilated/on oxygen as well as with respiratory symptoms and feeding problems at 1 year of age. Conclusion The CDH‐CT scoring tool has a good intraobserver and interobserver repeatability and correlates with relevant clinical parameters. This holds promise for its use in clinical follow‐up and as outcome parameter in clinical interventional studies.

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Multidisciplinary long-term follow-up of congenital diaphragmatic hernia: A growing trend

Cited by 31 publications

References 64 publications

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes

Sepsis risk factors in infants with congenital diaphragmatic hernia

Chest CT scoring for evaluation of lung sequelae in congenital diaphragmatic hernia survivors

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