[Long-term results of patients with congenital diaphragmatic hernia]. 2009

C Menéndez, and M Fariñas, and A Parente, and A Laín, and M Fanjul, and P Chimenti, and N Carrera, and A Huerga, and C Corona, and I Marsinyach, and A Cañizo, and S Villar, and M Sánchez-Luna, and J Vázquez
Servicio Neonatología, Hospital Infantil Gregorio Marañón, Madrid.

OBJECTIVE Introduction of advanced therapeutic modalities for diaphragmatic congenital hernia (CDH) has allowed to reach considerable improvements in survival rate. Nevertheless, there are few studies which analyze the clinical evolution of the long-term survivors. The aim of this work is to analyze the outcomes of the patients with CDH in our hospital. METHODS Fifty-five neonates with CDH were treated in our center between 1998 and 2005. We included in the study those patients that were alive at the moment of first hospital discharge (72%; n=40 patients). ECMO therapy was needed in 6 of them during neonatal treatment. A descriptive transverse review of the clinical record as well as a telephonic interview to the parents was performed for the respiratory, cardiological, digestive and neurological conditions, following standard diagnostic studies in every case. The mean age of the children in the moment of the study was 4.2 years (1-9). RESULTS The 8.3% of the children needed domiciliary oxygen therapy during a maximum of 3 months in all the cases. 22% of the cases suffered from respiratory problems, being bronchiolitis and pneumonia the most frequent diagnoses. Only a patient developed asthma. The gastroesophageal reflux is the most frequent long-term condition (47%), but only 8.3% needs surgical treatment. Regarding to cardiological problems, 14% developed pulmonary hypertension, being slight - moderate in all the cases but in one case who was the only deceased of the series. Regarding to neurological problems only 1 patient developed serious alterations (brain paralysis), having suffered a hemorrhage parenquimatosa during the treatment with ECMO. No other patient presents motor, visual nor auditory alterations in the development, last mild alteration in language (4 patients). Differences do not exist with the group of patients that did not need ECMO during the treatment in cardiological and digestive complications, being higher percentage with respiratory problems. CONCLUSIONS In our sample only 2 patients present serious sequels (5%). Of this preliminary study we can conclude that the comorbility in the CDH is very low having these patient a good development and good quality of life.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D006548 Hernia, Diaphragmatic Protrusion of abdominal structures into the THORAX as a result of congenital or traumatic defects in the respiratory DIAPHRAGM. Diaphragmatic Hernia,Diaphragmatic Hernias,Hernias, Diaphragmatic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D065630 Hernias, Diaphragmatic, Congenital Protrusion of abdominal structures into the THORAX as a result of embryologic defects in the DIAPHRAGM often present in the neonatal period. It can be isolated, syndromic, non-syndromic or be a part of chromosome abnormality. Associated pulmonary hypoplasia and PULMONARY HYPERTENSION can further complicate stabilization and surgical intervention. Bochdalek Hernia,Congenital Diaphragmatic Hernia,Congenital Diaphragmatic Hernias,Morgagni Hernia,Morgagni's Hernia,Agenesis of Hemidiaphragm,Bochdalek Hernias,Congenital Diaphragmatic Defect,Morgagni Hernias,Morgagni's Hernias,Unilateral Agenesis of Diaphragm,Congenital Diaphragmatic Defects,Defect, Congenital Diaphragmatic,Defects, Congenital Diaphragmatic,Diaphragm Unilateral Ageneses,Diaphragm Unilateral Agenesis,Diaphragmatic Defect, Congenital,Diaphragmatic Defects, Congenital,Diaphragmatic Hernia, Congenital,Diaphragmatic Hernias, Congenital,Hemidiaphragm Ageneses,Hemidiaphragm Agenesis,Hernia, Bochdalek,Hernia, Congenital Diaphragmatic,Hernia, Morgagni,Hernia, Morgagni's,Hernias, Bochdalek,Hernias, Congenital Diaphragmatic,Hernias, Morgagni,Hernias, Morgagni's,Morgagnis Hernia,Morgagnis Hernias

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