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Lung function at follow-up of infants with surgically correctable anomalies.

Michael Prendergast1, Gerrard F Rafferty, Anthony D Milner

  • 1Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, United Kingdom.

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Infants with congenital diaphragmatic hernia (CDH) show different lung function post-surgery compared to anterior wall defect (AWD) infants. Fetal lung volume (FLV) may predict these lung function outcomes in infants with surgical anomalies.

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Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Pulmonary Medicine

Background:

  • Infants with congenital diaphragmatic hernia (CDH) and anterior wall defects (AWD) may experience abnormal fetal lung growth.
  • CDH infants might face a higher risk of antenatal lung growth abnormalities compared to AWD infants.

Purpose of the Study:

  • To test if CDH infants exhibit worse lung function than AWD infants after surgical correction.
  • To determine the correlation between fetal lung volume (FLV) and post-surgical lung function in these infant groups.

Main Methods:

  • Lung function was assessed in 13 CDH and 13 AWD infants (median age 11 months) using plethysmography (FRCpleth, Raw) and helium gas dilution (FRCHe).
  • Tidal breathing parameters (T(PTEF):Te) and respiratory system compliance (Crs) and resistance (Rrs) were measured.
  • Fetal lung volume (FLV) was evaluated using 3D ultrasound and virtual organ computer-aided analysis in 17 infants.

Main Results:

  • CDH infants had a significantly higher median FRCpleth (41 ml/kg) compared to AWD infants (37 ml/kg, P=0.043).
  • CDH infants demonstrated significantly lower median Crs (1.45 ml/cm H2O/kg) than AWD infants (2.78 ml/cm H2O/kg, P=0.041).
  • FRCpleth results showed a significant positive correlation with FLV (r=0.721, P<0.001).

Conclusions:

  • Infants with CDH present with significantly different lung function outcomes post-surgery compared to AWD infants.
  • Fetal lung volume measurements show potential as a predictor for lung function abnormalities in infants with surgically correctable anomalies.