title: Pulmonary vascular resistance in repaired congenital diaphragmatic hernia vs. age-matched controls.
abstract: BACKGROUND
  Infants and children with repaired congenital diaphragmatic hernia (CDH) often continue to show delayed growth and development that may be, in part, secondary to unrecognized persistence of increased pulmonary vascular resistance (PVR).
  
  
  METHODS
  Data were reviewed from all patients ages 6-36 mo with repaired CDH who underwent cardiac catheterization from 2007 to 2010 and were compared to data from a control population of patients undergoing percutaneous closure of a patent ductus arteriosus (PDA). Indexed pulmonary blood flow (Qp), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and PVR were examined.
  
  
  RESULTS
  Data from 8 CDH patients and 10 control patients were examined. The mPAP (22.5 ± 3.33 vs. 18.2 ± 4.13 mm Hg) and PVR (3.66 ± 0.79 vs. 1.22 ± 0.4 iwU (indexed Wood's units)) were both significantly elevated in the CDH population, whereas the Qp (4.08 ± 1.43 vs. 6.82 ± 1.46 l/min/m(2)) was significantly lower in this population. There was no significant difference in pulmonary capillary wedge pressure (PCWP). Less than half of the CDH patients had signs of pulmonary hypertension (PH) on echocardiogram.
  
  
  CONCLUSIONS
  Our data suggest that children who are ages 6-36 mo with repaired CDH have significantly increased PVR compared with controls and early consideration of cardiac catheterization may be warranted.
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. matthew.zussman@cchmc.org
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Zussman
authors.forename: Michelle
authors.initials: M
authors.lastname: Bagby
authors.forename: D Woodrow
authors.initials: DW
authors.lastname: Benson
authors.forename: Resmi
authors.initials: R
authors.lastname: Gupta
authors.forename: Russel
authors.initials: R
authors.lastname: Hirsch
mesh_terms: D006328:Cardiac Catheterization; D016022:Case-Control Studies; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006548:Hernia, Diaphragmatic / Q000503:physiopathology / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D008297:Male; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012189:Retrospective Studies; D014655:Vascular Resistance / Q000502:physiology*