title: Does Ventilatory Time Retain Its Validity in Predicting Neurodevelopmental Outcome at Two Years of Age in High-Risk Congenital Diaphragmatic Hernia Survivors?
abstract: ObjectiveTo evaluate if in high-risk non-extracorporeal membrane oxygenation (ECMO)-treated congenital diaphragmatic hernia (CDH) survivors, ventilatory time (VT) is correlated to and can be used as clinical marker of neurodevelopmental delay at 2 years of age.Study DesignCohort study was conducted between 2008 and 2012. Mental, motor, and language development were assessed by the Bayley Scales of Infant and Toddler Development III. The correlation between VT and neurodevelopmental outcome (NDO) was analyzed using Pearson's test. Receiver operating characteristic (ROC) analysis was performed to determine the accuracy and best cutoff value of VT to predict the risk of neurodevelopmental delay. Statistical significance was set atp< 0.05.ResultsA total of 49 patients form the subject of this study. VT during first admission was inversely correlated with cognitive (r= -0.4116;p= 0.0033), motor (r= -0.4241;p= 0.0024), and language development (r= -0.3564;p= 0.0119). Using ROC curve analysis, VT was a significant predictor for neurodevelopmental delay in the cognitive (area under the curve [AUC]: 0.864, sensitivity: 100; specificity: 66.67;p< 0.0001) and motor (AUC: 0.902; sensitivity: 100; specificity: 73.17;p< 0.0001) scales, but not in the language scale. The best cutoff value for both scales was 9 days.ConclusionWithin a population of high-risk non-ECMO-treated CDH survivors, VT appears to retain its validity as a clinical marker of adverse NDO in cognitive and motor domains.
authors.affiliation: Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bevilacqua
authors.affiliation: Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Morini
authors.affiliation: Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zaccara
authors.affiliation: Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Valfrè
authors.affiliation: Department of Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Lelia Rotondi
authors.initials: LR
authors.lastname: Aufiero
authors.affiliation: Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Gentile
authors.affiliation: Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Bagolan
authors.affiliation: Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Aite
mesh_terms: D002675:Child, Preschool; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D000068079:Motor Disorders / Q000175:diagnosis / Q000209:etiology*; D009048:Motor Skills; D011379:Prognosis; D012372:ROC Curve; D012121:Respiration, Artificial; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors