Neurodevelopmental outcome in congenital diaphragmatic hernia survivors: role of ventilatory time.
BACKGROUND
Neurodevelopmental impairment is one of the most significant morbidities among CDH survivors.


OBJECTIVE
Assess correlation between ventilatory time (VT) and short-term neurodevelopmental outcome in congenital diaphragmatic hernia (CDH) survivors.


METHODS
A prospective longitudinal study was conducted between 2008 and 2012. Assessment of mental and motor development was performed at 6 and 12months by Bayley Scales of Infant and Toddler Development - 3rd Edition (BSID-III). ROC curve analysis was used.


RESULTS
Forty-two subjects were included in the study. There was a significant inverse correlation between neurodevelopment at 6 and 12months and VT during first admission (p<0.0001). VT predicting the risk of moderate (BSID-III <85) and severe (BSID-III <70) delay was 13 and 28days, respectively (area under the curve - delay <85: 6months mental 0.943 and motor 0.992; 12months mental 0.877 and motor 0.925; delay <70: 6months mental 0.934 and motor 0.943; 12months mental 0.906 and motor 0.975; p<0.0001).


CONCLUSIONS
VT should be considered an important marker to identify subjects at risk for short-term neurodevelopmental delay in CDH survivors. Early follow-up intervention therapy should be activated in every baby with a history exceeding 13days of VT.
Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
Francesca
F
Bevilacqua
Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Francesco
F
Morini
Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
Antonio
A
Zaccara
Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Laura
L
Valfrè
Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Irma
I
Capolupo
Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Pietro
P
Bagolan
Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy. Electronic address: lucia.aite@opbg.net.
Lucia
L
Aite
D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D015996:Survival Rate / Q000639:trends
Congenital diaphragmatic hernia; Neurodevelopmental outcome; Ventilatory strategy