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Long-term follow-up of congenital diaphragmatic hernia
Laura E Hollinger1, Matthew T Harting1, Kevin P Lally1
1Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, 6431 Fannin St, MSB 5.233, Houston, Texas 77030.
Insights
Survivors of congenital diaphragmatic hernia (CDH) face complex health issues, requiring specialized multidisciplinary care. This study outlines challenges and a follow-up program for these unique patients.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Developmental Pediatrics
Background:
- Increased survival rates in congenital diaphragmatic hernia (CDH) have led to a growing population of long-term survivors.
- These survivors present with complex, multifaceted medical and surgical needs requiring ongoing management.
- Disease-specific morbidities present opportunities for interdisciplinary collaboration and research into late outcomes.
Purpose of the Study:
- To characterize the specific long-term challenges faced by congenital diaphragmatic hernia survivors.
- To propose an algorithm for a structured, multidisciplinary follow-up program for CDH survivors.
- To improve comprehensive care and outcomes for this unique patient cohort.
Main Methods:
- Review of existing literature on CDH survivor outcomes.
- Analysis of common morbidities in pediatric and adult CDH patients.
- Development of a proposed follow-up care algorithm based on identified challenges.
Main Results:
- CDH survivors frequently experience impaired pulmonary function.
- Altered neurodevelopmental outcomes, nutritional insufficiency, and musculoskeletal changes are common.
- Specialized surgical needs necessitate regular monitoring and intervention, especially in severe cases.
Conclusions:
- Long-term, comprehensive follow-up is essential for congenital diaphragmatic hernia survivors.
- A multidisciplinary approach is critical to address the diverse health needs of these patients.
- The proposed algorithm aims to standardize and optimize long-term care for CDH survivors.
Abstract:
Increased survival of patients with congenital diaphragmatic hernia has created a unique cohort of children, adolescent, and adult survivors with complex medical and surgical needs. Disease-specific morbidities offer the opportunity for multiple disciplines to unite together to provide long-term comprehensive follow-up, as well as an opportunity for research regarding late outcomes. These children can exhibit impaired pulmonary function, altered neurodevelopmental outcomes, nutritional insufficiency, musculoskeletal changes, and specialized surgical needs that benefit from regular monitoring and intervention, particularly in patients with increased disease severity. Below we aim to characterize the specific challenges that these survivors face as well as present an algorithm for a multidisciplinary long-term follow-up program.
