Diaphragmatic function in infants and children with congenital diaphragmatic hernia: a cross-sectional study
| Autor: | Sonia Khirani, Jorge Olmo Arroyo, Alexandre Lapillonne, Brigitte Fauroux, Odile Becquet, Christophe Delacourt, Naziha Khen-Dunlop, Sylvie Beaudoin, V. Rousseau, Elsa Kermorvant-Duchemin, Alessandro Amaddeo |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Cross-sectional study Diaphragm Diaphragmatic breathing 03 medical and health sciences 0302 clinical medicine Breathing pattern 030225 pediatrics medicine Hospital discharge Humans Crying business.industry Respiration Infant Newborn Congenital diaphragmatic hernia Infant General Medicine medicine.disease Respiratory Muscles Diaphragm (structural system) Cross-Sectional Studies 030228 respiratory system Time index Anesthesia Child Preschool Surgery Female medicine.symptom Cardiology and Cardiovascular Medicine business Hernias Diaphragmatic Congenital |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 53(4) |
| ISSN: | 1873-734X |
| Popis: | OBJECTIVES Few studies have evaluated long-term diaphragmatic function in congenital diaphragmatic hernia (CDH). The aim of our cross-sectional study was to assess diaphragmatic function in infants and young children with CDH after surgical repair. METHODS All the patients with CDH repair followed in our centre between February 2014 and January 2016 were enrolled. Patients with a postnatal diagnosis after 1 month of life were excluded. Breathing pattern and diaphragmatic function were assessed using esophageal and gastric (Pgas) pressure recording after surgery, or at 1 or 5 years of age. RESULTS Twenty-eight patients (24 left-sided CDH, 6 with diaphragmatic patch) were included. Twelve patients were assessed before hospital discharge (Y0), 6 around the age of 1 year (Y1) and 10 around the age of 5 years (Y5). Mean antenatal estimated pulmonary volume (VLA) was 42 ± 10% (n = 23). Diaphragmatic strength, assessed by transdiaphragmatic pressure during crying/sniff, was low at Y0 (47 ± 18 cmH2O, n = 12) and within normality at Y5 (81 ± 15 cmH2O, n = 7). Diaphragmatic dysfunction, assessed by Pgas during crying/sniff, was present at Y0 (-58 ± 22 cmH2O, n = 12) and Y1 (-53 ± 36 cmH2O, n = 5) and still present at Y5 (3 ± 9 cmH2O, n = 7) but to a lesser extent. The diaphragmatic tension time index (TTdi), which estimates diaphragmatic endurance, was high at Y0 (0.10 ± 0.04, n = 11) and within normality at Y5 (0.03 ± 0.01, n = 6). VLA correlated with neonatal TTdi (r = -0.961, P |
| Databáze: | OpenAIRE |
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