Original articleNeurodevelopmental outcome of infants with congenital diaphragmatic hernia prospectively enrolled in an interdisciplinary follow-up program☆
Section snippets
Material and methods
This study was approved by The Children's Hospital of Philadelphia Institutional Review Board, Committee for Protection of Human Subjects (2004-5-3779). Informed consent was obtained from the parents or legal guardians.
Patient population
During the study period, overall, 52 CDH survivors were enrolled in our follow-up program. Of those, 41 (79%) infants were at least 6 months and had returned for detailed neurodevelopmental assessment. Patient characteristics and neonatal hospital course are summarized in Table 1. Gestational age at birth was greater then 36 weeks in 34 (83%) children, between 35 and 36 weeks in 2 (5%), and less then 34 weeks in 5 (12%).
Neurodevelopmental outcome
Each child's most recent neurodevelopmental and neurologic assessment (ie,
Discussion
As technology and sophistication of both neonatal and surgical care (eg, permissive hypercapnia, lung-preserving ventilation strategies, high-frequency ventilation, ECMO) have advanced, survival rates of more severely affected CDH children (liver up and an LHR <1.0) have improved [16]. Although improving short-term morbidity and mortality is an important goal, more recent and ongoing research has been focused on neurodevelopmental outcome as an equally important primary outcome in this
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Presented in part at the 39th Annual Meeting of the American Pediatric Surgical Association in Phoenix, AZ, May 2008.