Longitudinal Analysis of Ventilation Perfusion Mismatch in Congenital Diaphragmatic Hernia Survivors - 20/03/20
Abstract |
Objective |
To determine the natural history of pulmonary function for survivors of congenital diaphragmatic hernia (CDH).
Study design |
This was a retrospective cohort study of survivors of CDH born during 1991-2016 and followed at our institution. A generalized linear model was fitted to assess the longitudinal trends of ventilation (V), perfusion (Q), and V/Q mismatch. The association between V/Q ratio and body mass index percentile as well as functional status was also assessed with a generalized linear model.
Results |
During the study period, 212 patients had at least one V/Q study. The average ipsilateral V/Q of the cohort increased over time (P < .01), an effect driven by progressive reduction in relative perfusion (P = .012). A higher V/Q ratio was correlated with lower body mass index percentile (P < .001) and higher probability of poor functional status (New York Heart Association class III or IV) (P = .045).
Conclusions |
In this cohort of survivors of CDH with more severe disease characteristics, V/Q mismatch worsens over time, primarily because of progressive perfusion deficit of the ipsilateral side. V/Q scans may be useful in identifying patients with CDH who are at risk for poor growth and functional status.
Le texte complet de cet article est disponible en PDF.Keywords : congenital diaphragmatic hernia, ventilation, perfusion, generalized linear model, generalized estimating equations
Abbreviations : BMI, CDH, ECMO, GLM, NYHA, Q, V
Plan
| Funded by the National Institutes of Health (5T32HL007734 [to D.D.]). The funder had no role in study design, data analysis, decision to publish, or preparation of the manuscript. The authors declare no financial conflict of interest. |
Vol 219
P. 160 - avril 2020 Retour au numéro
Article précédent
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