Ss. Marven et al., PULMONARY-FUNCTION, EXERCISE PERFORMANCE, AND GROWTH IN SURVIVORS OF CONGENITAL DIAPHRAGMATIC-HERNIA, Archives of Disease in Childhood, 78(2), 1998, pp. 137-142
A cohort of survivors of congenital diaphragmatic hernia (CDH), with m
atched controls, was studied to assess growth, respiratory function, a
nd exercise performance. Nineteen of 24 survivors from an 11 year peri
od (79%) were compared with 19 matched controls. Subjects had detailed
auxology, performed spirometry and cycle ergometry, and completed que
stionnaires about respiratory symptoms and exercise. There were no sig
nificant differences between the groups for height, weight, sitting he
ight, head circumference, or body mass index expressed as SD scores. T
he mean (95% confidence interval) percentage predicted forced vital ca
pacity (FVC) was 84.7% (79.1 to 90.3) in index cases and 96.5% (91.4 t
o 101.6) in controls (p < 0.01). There was no significant difference i
n total lung capacity. Expiratory flow rates corrected for FVC were al
so similar between groups, suggesting normal airway function relative
to lung size. Mean maximum oxygen consumption in ml/kg/min was 40.1 (3
6.8 to 43.4) and 42.2 (38.5 to 45.8) in index and control cases. These
differences were not significant. Index cases achieved a similar minu
te ventilation to controls by more rapid and shallower breathing. Inde
x cases had lower perception of their own fitness and lower enjoyment
of exercise, although habitual activity levels were similar. Survivors
off CDH repair have reduced functional lung volumes, but normal airwa
y function compared with matched controls. They have no growth impairm
ent nor significant impairment of exercise performance, although they
have more negative perceptions of their own fitness. They should be en
couraged and expected to participate fully in sport and exercise.