Pulmonary function, exercise performance, and growth in survivors of congenital diaphragmatic hernia
a University Department of
Paediatrics, Sheffield Children's Hospital, b Sport and Exercise Laboratory, Sheffield Hallam
University
Correspondence to: Dr C V E Powell, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH.
Accepted 6 September 1997
A cohort of survivors of congenital diaphragmatic hernia (CDH),
with matched controls, was studied to assess growth, respiratory function, and exercise performance. Nineteen of 24 survivors from an 11 year period (79%) were compared with 19 matched controls. Subjects had
detailed auxology, performed spirometry and cycle ergometry, and
completed questionnaires about respiratory symptoms and exercise. There
were no significant differences between the groups for height, weight,
sitting height, head circumference, or body mass index expressed as SD
scores. The mean (95% confidence interval) percentage predicted forced
vital capacity (FVC) was 84.7% (79.1 to 90.3) in index cases and
96.5% (91.4 to 101.6) in controls (p < 0.01). There was no
significant difference in total lung capacity. Expiratory flow rates
corrected for FVC were also similar between groups, suggesting normal
airway function relative to lung size. Mean maximum oxygen consumption
in ml/kg/min was 40.1 (36.8 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 minute ventilation to controls by more rapid and
shallower breathing. Index cases had lower perception of their own
fitness and lower enjoyment of exercise, although habitual activity
levels were similar. Survivors of CDH repair have reduced functional lung volumes, but normal airway function compared with matched controls. They have no growth impairment nor significant impairment of
exercise performance, although they have more negative perceptions of
their own fitness. They should be encouraged and expected to participate fully in sport and exercise.
© 1998 by Archives of Disease in Childhood
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