Pulmonary function in infants with congenital diaphragmatic hernia

Objective To assess the pulmonary function recovery of infants with congenital diaphragmatic hernia (CDH). Methods The medical records were retrospectively reviewed for CDH infants receiving pulmonary function test (PFT) from November 2016 to March 2019. The relevant data included lung function, follow-up time, gender, sideness of hernia, Apgar score, birth weight, location of liver, admission arterial blood gas analysis, duration of mechanical ventilation and length of hospital stay. Results Forty-five infants were included for analysis. There were 19 boys and 26 girls. And the involved side was left (n=39) and right (n=6). PFT was performed for a total of 89 cases. The mean age at PFT was (9.3±7.3) months. And the frequency of PFT was once (n=20) and twice and more (n=25). Pulmonary function was normal (n=7, 15.6%) and abnormal (n=38, 84.4%). The results were normal pulmonary function (n=10), airflow obstruction (n=62), mixed ventilatory dysfunction (n=11) and airflow restriction (n=6). Significant correlation existed between lung function and age at PFT, sideness of hernia and liver herniation (all P<0.05). Compared with counterparts with airflow restriction, those with airflow obstruction had a later age of PFT [(8.9±6.9) vs.(1.3±05) months, P=0.001]. As compared with previous indices, percent of expiratory time to peak tidal time and percent of tidal volume to peak tidal expiratory flow increased subsequently. Conclusions Pulmonary function abnormality is present in some CDH survivors after repairing. Lung function may be correlated with age at PFT, sideness of hernia and liver herniation.