Long-term follow-up of congenital diaphragmatic hernia

Hollinger, Laura E.; Harting, Matthew T.; Lally, Kevin P.

doi:10.1053/j.sempedsurg.2017.04.007

Cited by 52 publications

(23 citation statements)

References 80 publications

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“…Today, nearly 75% of infants with CDH are discharged with one or more major comorbidity, including severe gastrointestinal, pulmonary, and neurological issues, in 61.7%, 30.2%, and 20.4% respectively [47]. Due to the increasing complexity of CDH patient care and associated long-term sequelae, there is a growing trend of multidisciplinary follow-up [48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic hernia: a scientometric analysis of the global research activity and collaborative networks

2018

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Despite a growing interest to clinicians and scientists, there is no comprehensive study that examines the global research activity on congenital diaphragmatic hernia (CDH). A search strategy for the Web of Science™ database was designed to identify scientific CDH publications. Research output of countries, institutions, individual authors, and collaborative networks was analyzed. Semi-qualitative research measures including citation rate and h-index were assessed. Choropleth mapping and network diagrams were employed to visualize results. A total of 3669 publications were found, originating from 76 countries. The largest number was published by the USA (n = 1250), the UK (n = 279), and Canada (n = 215). The USA combined the highest number of cooperation articles (n = 152), followed by Belgium (n = 115) and the Netherlands (n = 93). The most productive collaborative networks were established between UK/Belgium (n = 53), Belgium/Spain (n = 47), and UK/Spain (n = 34). Canadian publications received the highest average citation rate (22.8), whereas the USA had the highest country-specific h-index (72). Eighty-five (2.3%) articles were published by international multicenter consortiums and national research networks. The most productive institutions and authors were based in North America and Europe. Over the past decades, CDH research has increasingly become multidisciplinary and numerous innovative therapeutic strategies were introduced. CDH-related research has constantly been progressing, involving today many disciplines with main research endeavors concentrating in a few high-income countries. Recent advances in prenatal interventions and regenerative medicine therapy hold the promise of improving CDH outcome in the 21st century. International collaborations and translational research should be strengthened to allow further evolution in this field.

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Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic hernia: a scientometric analysis of the global research activity and collaborative networks

2018

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“…Original research meta-analysis. This review focuses on congenital gastrointestinal malformations other than congenital diaphragmatic hernia (CDH), to not include the confounding effect of the pulmonary comorbidity in patients with CDH, [31][32][33] which may require treatment with extracorporeal membrane oxygenation. 34 35 The secondary aim is to study differences between specific types of congenital gastrointestinal malformations and the contribution of possible moderating factors for neurodevelopmental impairment, using meta-regression.…”

Section: What This Study Adds?mentioning

confidence: 99%

Neurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis

Roorda

Königs

Schattenkerk

et al. 2021

Arch Dis Child Fetal Neonatal Ed

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AimChildren with congenital gastrointestinal malformations may be at risk of neurodevelopmental impairment due to challenges to the developing brain, including perioperative haemodynamic changes, exposure to anaesthetics and postoperative inflammatory influences. This study aggregates existing evidence on neurodevelopmental outcome in these patients using meta-analysis.MethodPubMed, Embase and Web of Science were searched for peer-reviewed articles published until October 2019. Out of the 5316 unique articles that were identified, 47 studies met the inclusion criteria and were included. Standardised mean differences (Cohen’s d) between cognitive, motor and language outcome of patients with congenital gastrointestinal malformations and normative data (39 studies) or the studies’ control group (8 studies) were aggregated across studies using random-effects meta-analysis. The value of (clinical) moderators was studied using meta-regression and diagnostic subgroups were compared.ResultsThe 47 included studies encompassed 62 cohorts, representing 2312 patients. Children with congenital gastrointestinal malformations had small-sized cognitive impairment (d=−0.435, p<0.001; 95% CI −0.567 to −0.302), medium-sized motor impairment (d=−0.610, p<0.001; 95% CI −0.769 to −0.451) and medium-sized language impairment (d=−0.670, p<0.001; 95% CI −0.914 to −0.425). Patients with short bowel syndrome had worse motor outcome. Neurodevelopmental outcome was related to the number of surgeries and length of total hospital stay, while no relations were observed with gestational age, birth weight, age and sex.InterpretationThis study shows that children with congenital gastrointestinal malformations exhibit impairments in neurodevelopmental outcome, highlighting the need for routine screening of neurodevelopment during follow-up.

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“…Among these, long-term neurological sequelae raise particular concern [3], although studies describing the neurological outcome of CDH survivors who are not treated with neonatal ECMO are limited [4]. Earlier studies report long-term outcomes, with evidence of impaired language and visual motor skills, behavioral, cognitive and developmental delay and hearing loss [5][6][7][8][9][10]. This evidence was further confirmed for short-term evaluation, where neurodevelopmental assessment at one year of age revealed mild (44%) and severe (13%) delay in at least one domain among cognitive, language and motor functions, depending on several determinants such as intubation, oxygen requirement and intensive care unit stay [4,11].…”

Section: Introductionmentioning

confidence: 99%

Morphometric Analysis of Brain in Newborn with Congenital Diaphragmatic Hernia

et al. 2021

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Congenital diaphragmatic hernia (CDH) is a severe pediatric disorder with herniation of abdominal viscera into the thoracic cavity. Since neurodevelopmental impairment constitutes a common outcome, we performed morphometric magnetic resonance imaging (MRI) analysis on CDH infants to investigate cortical parameters such as cortical thickness (CT) and local gyrification index (LGI). By assessing CT and LGI distributions and their correlations with variables which might have an impact on oxygen delivery (total lung volume, TLV), we aimed to detect how altered perfusion affects cortical development in CDH. A group of CDH patients received both prenatal (i.e., fetal stage) and postnatal MRI. From postnatal high-resolution T2-weighted images, mean CT and LGI distributions of 16 CDH were computed and statistically compared to those of 13 controls. Moreover, TLV measures obtained from fetal MRI were further correlated to LGI. Compared to controls, CDH infants exhibited areas of hypogiria within bilateral fronto-temporo-parietal labels, while no differences were found for CT. LGI significantly correlated with TLV within bilateral temporal lobes and left frontal lobe, involving language- and auditory-related brain areas. Although the causes of neurodevelopmental impairment in CDH are still unclear, our results may suggest their link with altered cortical maturation and possible impaired oxygen perfusion.

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Long-term follow-up of congenital diaphragmatic hernia

Cited by 52 publications

References 80 publications

Congenital diaphragmatic hernia: a scientometric analysis of the global research activity and collaborative networks

Congenital diaphragmatic hernia: a scientometric analysis of the global research activity and collaborative networks

Neurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis

Morphometric Analysis of Brain in Newborn with Congenital Diaphragmatic Hernia

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