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  • Title: Neurodevelopmental outcome in congenital diaphragmatic hernia survivors: role of ventilatory time.
    Author: Bevilacqua F, Morini F, Zaccara A, Valfrè L, Capolupo I, Bagolan P, Aite L.
    Journal: J Pediatr Surg; 2015 Mar; 50(3):394-8. PubMed ID: 25746695.
    Abstract:
    BACKGROUND: Neurodevelopmental impairment is one of the most significant morbidities among CDH survivors. PURPOSE: Assess correlation between ventilatory time (VT) and short-term neurodevelopmental outcome in congenital diaphragmatic hernia (CDH) survivors. METHODS: A prospective longitudinal study was conducted between 2008 and 2012. Assessment of mental and motor development was performed at 6 and 12months by Bayley Scales of Infant and Toddler Development - 3rd Edition (BSID-III). ROC curve analysis was used. RESULTS: Forty-two subjects were included in the study. There was a significant inverse correlation between neurodevelopment at 6 and 12months and VT during first admission (p<0.0001). VT predicting the risk of moderate (BSID-III <85) and severe (BSID-III <70) delay was 13 and 28days, respectively (area under the curve - delay <85: 6months mental 0.943 and motor 0.992; 12months mental 0.877 and motor 0.925; delay <70: 6months mental 0.934 and motor 0.943; 12months mental 0.906 and motor 0.975; p<0.0001). CONCLUSIONS: VT should be considered an important marker to identify subjects at risk for short-term neurodevelopmental delay in CDH survivors. Early follow-up intervention therapy should be activated in every baby with a history exceeding 13days of VT.
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