Ann Surg Treat Res.  2020 Apr;98(4):206-213. 10.4174/astr.2020.98.4.206.

Risk factors affecting postoperative pulmonary function in congenital diaphragmatic hernia

• Wang Q
• Liu Q
• Zang J
• Wang J
• Chen J

• KMID: 2500821
• DOI: http://doi.org/10.4174/astr.2020.98.4.206

Abstract

Purpose
It is well known that congenital diaphragmatic hernia (CDH) in infants impacts pulmonary function rehabilitation after surgery. However, the risk factors of postoperative pulmonary function are still unclear. In this research, we analyzed the potential risk factors of postoperative pulmonary function in CDH patients in order to improve the clinical management of CDH patients.
Methods
Thirty-three cases CDH infants followed were enrolled from November 2016 to September 2018. Clinical data were reviewed. Tidal breathing pulmonary function testing was performed after surgery. Correlation between pulmonary function and clinical characteristics was evaluated using multivariate analysis of variance.
Results
Pulmonary dysfunction was detected in 87.9% patients (29 of 33). The defect size was found to be significantly larger in patients with obstructed and mixed ventilatory disorders (P = 0.001). Diagnosis of gestational age (GA) was also significantly earlier compared to restrictive ventilatory disorders (P = 0.001). Larger defect size, and earlier prenatal diagnosis of GA were detected in severe obstructive ventilatory disorders (P = 0.007, P = 0.001, retrospectively).
Conclusion
Most patients had various degrees of pulmonary dysfunction after surgery. Patients with larger defect size and earlier diagnosis time might be vulnerable to severe obstructive and mixed ventilatory disorders.

Keyword

Airway obstruction; Infant; Tidal volume

Figure

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  Fig. 1 Analysis of risk factors related to different ventilatory disorders. (A) Analysis of the diagnosis of gestational age related to different ventilatory disorders. (B) Analysis of defect size related to to different ventilatory disorders.

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  Fig. 2 Potential factors related to the severity of airway obstruction. (A) Defect size was positively related with the severity of airway obstruction (ρ = 0.543, P < 0.05). (B) Diagnosis of gestational age was negatively related with the severity of airway obstruction (ρ = −0.702, P < 0.05).

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  Fig. 3 Comparison between postoperative pulmonary function (PF) and follow-up PF at 3 months after discharge.

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