Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Danzer, Enrico; Gerdes, Marsha; D’Agostino, Jo Ann; Bernbaum, Judy; Hoffman, Casey; Herkert, Lisa M.; Rintoul, Natalie E.; Peranteau, William H.; Flake, Alan W.; Adzick, N. Scott; Hedrick, Holly L.

doi:10.1016/j.jpedsurg.2015.03.040

Cited by 36 publications

(19 citation statements)

References 17 publications

(56 reference statements)

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“…Delayed neurodevelopment in some of our CDH patients may be explained by perinatal and neonatal hypoxemia in the first days of life or by prolonged and recurrent hospitalizations. Poor neurodevelopmental outcomes most likely have multifactorial causes, and many are related to the acuity of CDH presentation . In our neonates treated with ECMO, the frequency of poor neurodevelopmental outcomes was 83%, which presumably reflects higher baseline disease acuity that required more extreme medical treatments.…”

Section: Discussionmentioning

confidence: 77%

“…Because ECMO increases the probability of survival in neonates with the most severe forms of CDH, it is not surprising that these survivors may manifest higher rates of postdischarge comorbid conditions than less-sick neonates who did not require ECMO (20). The most frequent chronic health issues in CDH survivors are pulmonary (4), gastrointestinal (20), and neurodevelopmental problems (21,22). All these adverse outcomes were present in our survivors with higher frequency in those who had ECMO, compared with neonates who had surgery only.…”

Section: Discussionmentioning

confidence: 99%

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Congenital diaphragmatic hernia: outcomes of neonates treated at Mayo Clinic with and without extracorporeal membrane oxygenation

Bojanić

Woodbury

Cavalcante

et al. 2017

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic hernia: outcomes of neonates treated at Mayo Clinic with and without extracorporeal membrane oxygenation

Bojanić

Woodbury

Cavalcante

et al. 2017

Pediatric Anesthesia

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show abstract

“…Despite this, some infants were reported by collaborating centres to have developmental impairment(s) and/or seizure activity. Future well-designed studies incorporating large patient numbers in registries/networks may uncover the true incidence of neurological and developmental sequelae including neurosensory impairment, epilepsy and autism 25–29. Parent groups, supported by medical professionals have long called for a national registry of infants with CHD to prospectively collect data on infant characteristics and outcomes (CDH UK Parent Group – Personal Communication, 2018).…”

Section: Discussionmentioning

confidence: 99%

One-year outcomes of infants born with congenital diaphragmatic hernia: a national population cohort study

Long

Bunch

Knight

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo report outcomes to 1 year, in infants born with congenital diaphragmatic hernia (CDH), explore factors associated with infant mortality and examine the relationship between surgical techniques and postoperative morbidity.DesignProspective national population cohort study.SettingPaediatric surgical centres in the UK and Ireland.MethodData were collected to 1 year for infants with CDH live-born between 1 April 2009 to 30 September 2010. Factors associated with infant mortality are explored using logistic regression. Postoperative morbidity following patch versus primary closure, minimally invasive versus open surgery and biological versus synthetic patch material is described. Data are presented as n (%) and median (IQR).ResultsOverall known survival to 1 year was 75%, 95% CI 68% to 81% (138/184) and postoperative survival 93%, 95% CI 88% to 97% (138/148). Female sex, antenatal diagnosis, use of vasodilators or inotropes, being small for gestational age, patch repair and use of surfactant were all associated with infant death. Infants undergoing patch repair had a high incidence of postoperative chylothorax (11/54 vs 2/96 in infants undergoing primary closure) and a long length of hospital stay (41 days, IQR 24–68 vs 16 days, IQR 10–25 in primary closure group). Infants managed with synthetic patch material had a high incidence of chylothorax (11/34 vs 0/19 with biological patch).ConclusionThe majority of infant deaths in babies born with CDH occur before surgical correction. Female sex, being born small for gestational age, surfactant use, patch repair and receipt of cardiovascular support were associated with a higher risk of death. The optimum surgical approach, timing of operation and choice of patch material to achieve lowest morbidity warrants further evaluation.

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“…50,52,55 The findings across published studies are difficult to compare because of variability in age at assessment and study design. In CDH survivors, Danzer 56 reported that 44% of infants had mild, and 13% severe neurodevelopmental delays in at least one domain at 1 year of age. Benjamin reported that 44% were at risk for neurocognitive delay at median age of 4.9 years.…”

Section: Literature Review Pulmonary Function a Literature Overview mentioning

confidence: 99%

Defining outcomes following congenital diaphragmatic hernia using standardised clinical assessment and management plan (SCAMP) methodology within the CDH EURO consortium

et al. 2018

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Treatment modalities for neonates born with congenital diaphragmatic hernia (CDH) have greatly improved in recent times with a concomitant increase in survival. In 2008, CDH EURO consortium, a collaboration of a large volume of CDH centers in Western Europe, was established with a goal to standardize management and facilitate multicenter research. However, limited knowledge on long-term outcomes restricts the identification of optimal care pathways for CDH survivors in adolescence and adulthood. This review aimed to evaluate the current practice of long-term follow-up within the CDH EURO consortium centers, and to review the literature on long-term outcomes published from 2000 onward. Apart from having disease-specific morbidities, children with CDH are at risk for impaired neurodevelopmental problems and failure of educational attainments which may affect participation in society and the quality of life in later years. Thus, there is every reason to offer them long-term multidisciplinary follow-up programs. We discuss a proposed collaborative project using standardized clinical assessment and management plan (SCAMP) methodology to obtain uniform and standardized follow-up of CDH patients at an international level.

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Neurodevelopmental outcome at one year of age in congenital diaphragmatic hernia infants not treated with extracorporeal membrane oxygenation

Cited by 36 publications

References 17 publications

Congenital diaphragmatic hernia: outcomes of neonates treated at Mayo Clinic with and without extracorporeal membrane oxygenation

Congenital diaphragmatic hernia: outcomes of neonates treated at Mayo Clinic with and without extracorporeal membrane oxygenation

One-year outcomes of infants born with congenital diaphragmatic hernia: a national population cohort study

Defining outcomes following congenital diaphragmatic hernia using standardised clinical assessment and management plan (SCAMP) methodology within the CDH EURO consortium

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