PULMONARY-FUNCTION, EXERCISE PERFORMANCE, AND GROWTH IN SURVIVORS OF CONGENITAL DIAPHRAGMATIC-HERNIA

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.