Neurodevelopmental outcome of infants with congenital diaphragmatic hernia prospectively enrolled in an interdisciplinary follow-up program

Danzer, Enrico; Gerdes, Marsha; Bernbaum, Judy; D’Agostino, JoAnn; Bebbington, Michael; Siegle, Jennifer; Hoffman, Casey; Rintoul, Natalie E.; Flake, Alan W.; Adzick, N. Scott; Hedrick, Holly L.

doi:10.1016/j.jpedsurg.2010.03.011

Cited by 99 publications

(81 citation statements)

References 44 publications

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“…As a consequence, morbidity plays an increasing role in patients with CDH. Not only pulmonary problems but also neurological disorders have been identified as significant morbidities among CDH survivors (5,6). In a study by McGahren et al, 8/12 (67%) ECMO survivors showed delayed neurological development compared to only 5/21(24%) of the non-ECMO-treated survivors.…”

Section: Abstract Aim: To Prospectively Evaluate Cerebral Perfusion mentioning

confidence: 99%

Cerebral Perfusion After Repair of Congenital Diaphragmatic Hernia with Common Carotid Artery Occlusion After ECMO Therapy

Henzler

Zöllner

Weis

et al. 2017

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Abstract. Aim: To prospectively evaluate cerebral perfusion after repair of congenital diaphragmatic hernia (CDH) and right-common-carotid-artery (rCCA) Congenital diaphragmatic hernia (CDH) occurs in approximately one in 3,000-4,000 live births (1). A defect of the diaphragm leads to herniation of abdominal organs into the thoracic cavity. Lung hypoplasia and secondary pulmonary hypertension are the major causes of death (2). The implementation of new therapeutic strategies has improved the survival rate even in those patients with severe CDH (3). If conservative treatment in newborns with CDH fails, extracorporeal membrane oxygenation (ECMO) therapy is an important alternative for accomplishing sufficient oxygenation of the newborns. The Congenital Diaphragmatic Hernia Study Group showed an improved survival rate in patients with CDH after ECMO therapy, in whom, without ECMO, mortality was predicted to be higher than 80% (4). As a consequence, morbidity plays an increasing role in patients with CDH. Not only pulmonary problems but also neurological disorders have been identified as significant morbidities among CDH survivors (5, 6). In a study by McGahren et al., 8/12 (67%) ECMO survivors showed delayed neurological development compared to only 5/21(24%) of the non-ECMO-treated survivors.In CDH, veno-arterial ECMO is usually performed. Vascular access is usually achieved by insertion of the ECMO cannulas through the right common carotid artery (rCCA) and the right internal jugular vein. At the time of decannulation, ligation or surgical reconstruction of the rCCA can be performed but secondary occlusion of the surgical reconstructed rCCA can occur (7). Büsing et al. investigated 2-year-old children with history of CDH and reconstruction of the rCCA after ECMO therapy. Their study showed that in 72% of the patients, the rCCA was found to be occluded or highly stenotic using contrast-enhanced magnetic resonance angiography (7). Using Doppler ultrasound in 5-year-old patients, Desai et al. reported that most of the reconstructed rCCAs after ECMO therapy were patent and in only 24% of the patients there was significant 557

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Section: Abstract Aim: To Prospectively Evaluate Cerebral Perfusion mentioning

confidence: 99%

Cerebral Perfusion After Repair of Congenital Diaphragmatic Hernia with Common Carotid Artery Occlusion After ECMO Therapy

Henzler

Zöllner

Weis

et al. 2017

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“…As liver position is a predictor of severity, it is not surprising that liver herniation is not only predictive of survival but also predicts impaired neurodevelopmental outcome. Nearly 80% of CDH children with prenatally diagnosed liver herniation demonstrated borderline or delayed neurodevelopmental, neurocognitive, and/or psychomotor outcome (Danzer et al, 2010).…”

Section: Liver Positionmentioning

confidence: 99%

“…Large hernia size-for which patch repair is a surrogate marker-strongly reduces overall survival as well as increases the risk of multiple adverse outcomes (D'Agostino et al, 1995;McGahren et al, 1997;Cortes et al, 2005;Congenital Diaphragmatic Hernia Study Group et al, 2007;Danzer et al, 2010). Patch repair correlates with higher long-term morbidity, increased rate of gastroesophageal reflux and altered pulmonary function tests, especially in the first 6 months of life (Valfrè et al, 2011).…”

Section: Size Of the Diaphragmatic Defectmentioning

confidence: 99%

“…Isolated CDH cases are more likely to survive and have lower morbidity than those occurring as part of a syndrome (Nobuhara et al, 1996;Doyle & K.P. Lally, 2004;Danzer et al, 2010).…”

Section: Associated Malformationsmentioning

confidence: 99%

“…Neurodevelopmental impairment is the most important morbidity among CDH survivors, apart from respiratory complications (D'Agostino et al, 1995;Nobuhara et al, 1996;McGahren et al, 1997;Danzer et al, 2010). At 8-12 years of age, mean IQ is 85 (1 SD below age expectations) (Bouman et al (2000), 45% have poor academic achievement, 50% are rated as having emotional and/or behavioral problems; by adolescent age, they have problems with sustained attention (39%) (Peetsold et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Mortality and Morbidity in Infants with CDH

Aly¹,

Abdel‐Hady²

2012

Congenital Diaphragmatic Hernia - Prenatal to Childhood Management and Outcomes

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School age educational outcomes of infants born with congenital diaphragmatic hernia

Walden

Nembhard

Akmyradov

et al. 2022

Birth Defects Research

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Background To compare academic proficiency among children with congenital diaphragmatic hernia (CDH) versus controls and identify predictors of academic performance among children with CDH. Methods Infants born with CDH in Arkansas, 2000–2005, were identified from the Arkansas Reproductive Health Monitoring System. For each case, two controls were selected from birth certificate data and matched for hospital and month of birth, sex, and race/ethnicity. Data on re‐hospitalization within the first 5 years and payer data were collected from the Arkansas Hospital Inpatient Discharge database. Surviving cases and controls were linked to the Arkansas Department of Education database. Primary outcomes were odds of proficiency on fourth grade literacy and mathematics achievement tests. Multivariable logistic regression models evaluated the association between study characteristics and academic proficiency. Results The final study cohort included 25 surviving CDH cases and 31 controls who were linked to their education data. After adjusting for differences in characteristics (5‐min Apgar score and associated congenital anomalies) between cases and controls, there were no statistically significant differences in literacy (72% vs. 84%, p = .93) or mathematics (64% vs. 81%, p = .98) test proficiency between the two groups. In multivariable analyses, among CDH cases, oxygen at discharge and Medicaid payer/longer hospital stay were associated with worse fourth grade literacy and mathematics proficiency, respectively. Conclusions Oxygen at discharge, Medicaid payer, and longer hospital stay were associated with lower academic performance among CDH cases.

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Neurodevelopmental outcome of infants with congenital diaphragmatic hernia prospectively enrolled in an interdisciplinary follow-up program

Cited by 99 publications

References 44 publications

Cerebral Perfusion After Repair of Congenital Diaphragmatic Hernia with Common Carotid Artery Occlusion After ECMO Therapy

Cerebral Perfusion After Repair of Congenital Diaphragmatic Hernia with Common Carotid Artery Occlusion After ECMO Therapy

Predictors of Mortality and Morbidity in Infants with CDH

School age educational outcomes of infants born with congenital diaphragmatic hernia

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