title: Lung function in young adults with congenital diaphragmatic hernia; a longitudinal evaluation.
abstract: BACKGROUND
  Survival rates of patients with congenital diaphragmatic hernia (CDH) have improved to up to 80%. Little is known about long-term consequences of the disease and its treatment. We evaluated lung function and respiratory symptoms longitudinally in a previously studied cohort of CDH patients and age-matched non-CDH patients who underwent similar neonatal intensive care treatment.
  
  
  METHODS
  We tested 27 young adults [mean (SD) age: 26.8 years (2.9)] with CDH and 30 non-CDH patients. Dynamic and static lung volumes, midexpiratory flows, and diffusion capacity were expressed as mean (SD) standard deviation scores. Prevalence of respiratory symptoms was evaluated with the European Community Respiratory Health Survey.
  
  
  RESULTS
  All data are expressed as mean (SD). FEF(25-75) in CDH patients had slightly deteriorated since childhood (CDH: -0.7 (1.4) vs. -1.6 (1.5), P < 0.001; non-CDH patients: 0.2 (1.4) vs. -0.3 (1.6), P = 0.038, ns). Diffusion capacity decreased in both groups (CDH: DL(CO) c 0.2 (1.1) vs. -1.5 (1.1), P <0.001; non-CDH: DL(CO) c 0.1 (0.4) vs. -1.1 (1.1), P < 0.001). Lung volumes were normal in both groups. The prevalence of asthma was higher than in the normal population (27.6% in patients and 30% in controls, P < 0.001).
  
  
  CONCLUSIONS
  Airflow obstruction and diffusion capacity deteriorated mildly from childhood into adulthood in survivors of CDH. The improved survival of patients with more severe forms of diaphragmatic hernia calls for long-term follow-up of lung function.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Spoel
authors.forename: Monique H M
authors.initials: MH
authors.lastname: van der Cammen-van Zijp
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Hanneke
authors.initials: H
authors.lastname: Ijsselstijn
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006548:Hernia, Diaphragmatic / Q000503:physiopathology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D055815:Young Adult