Follow Up of Nutritional Status in Postoperative Congenital Diaphragmatic Hernia Patients

Document Type : Research Paper

Authors

1 Department of Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran

2 Fellowship of pediatrics intensive care, department of pediatrics, Mashhad University Of Medical Sciences, Mashhad, Iran

3 Department of Nutrition, MSC of Nutrition Science, Faculty of Medicine, Mashhad University of Medical Sciences(MUMS), Mashhad, Iran

4 Neonatal research center, Faculty of medicine, Mashhad university of medical sciences

5 department of nutrition sciences, varastegan institute for medical sciences, Mashhad, Iran

6 Assistant professor of pediatrics, department of pediatrics, Mashhad University Of Medical Sciences, Mashhad, Iran

Abstract

Background: Failure to thrive (FTT) is a common underlying condition in patients with Congenital diaphragmatic hernia (CDH). The aim of current study was to evaluate nutritional status and growth pattern in CDH patients. Methods: In current study, we investigated a total of 146 CDH patients who had undergone surgery in Dr. Sheikh Hospital, Mashhad, Iran between April 2006 to November 2013. Due to inaccessibility or lack of cooperation by some parents, 61 cases completed the study. Demographic and anthropometric data along with postoperative complications were taken into consideration. Results: Among the 61 studied cases, 32.7% had died during the initial 6-months after surgery. The mean age of participants was 24.21 ± 30.26 months. According to Z-score classification of weight for height following surgery, 7.3% had severe malnutrition, 4.8% moderate malnutrition and 24.3% mild malnutrition while 51.2% were normal. While current evaluation indicates that the majority of subjects were in the normal range. Conclusion: Most children with congenital diaphragmatic hernia had a normal growth following surgery; however, few cases experienced a reduced growth rate in the early years of their life. Highlighting the need for additional calories to prevent FTT and other complications are recommended.

Keywords


1. Molinaro F, Angotti R, Ferrara F, Borruto F, Messina M, Becmeur F. Congenital diaphragmatic hernia.  Pediatric Thoracic Surgery: Springer; 2013. p. 227-32.
2. Jesudason E. Challenging embryological theories on congenital diaphragmatic hernia: future therapeutic implications for paediatric surgery. Annals of the Royal College of Surgeons of England. 2002;84(4):252.
3. McHoney M. Congenital diaphragmatic hernia. Early human development. 2014;90(12):941-6.
4. Kesieme EB, Kesieme CN. Congenital diaphragmatic hernia: review of current concept in surgical management. ISRN surgery. 2011;2011.
5.Iqbal CW. Congenital Diaphragmatic Hernia. Fetal Diagnosis and Therapy. 2013:8.
6.Muratore CS, Utter S, Jaksic T, Lund DP, Wilson JM. Nutritional morbidity in survivors of congenital diaphragmatic hernia. Journal of pediatric surgery. 2001;36(8):1171-6.
7. Lally KP, Engle W. Postdischarge follow-up of infants with congenital diaphragmatic hernia. Pediatrics. 2008;121(3):627-32.
8.Frisk V, Jakobson LS, Unger S, Trachsel D, O'Brien K. Long-term neurodevelopmental outcomes of congenital diaphragmatic hernia survivors not treated with extracorporeal membrane oxygenation. Journal of pediatric surgery. 2011;46(7):1309-18.
9.Mol BW, Kilby MD. The future: fetal therapy and translational studies: global alignment, coordination, and collaboration in perinatal research: The Global Obstetrics Network. Fetal Therapy: Scientific Basis and Critical Appraisal of Clinical Benefits. 2012:433.
10.Leeuwen L, Walker K, Halliday R, Karpelowsky J, Fitzgerald DA. Growth in children with congenital diaphragmatic hernia during the first year of life. Journal of pediatric surgery. 2014;49(9):1363-6.
11.Peetsold M, Heij H, Kneepkens C, Nagelkerke A, Huisman J, Gemke R. The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity. Pediatric surgery international. 2009;25(1):1-17.
12.Fasching G, Huber A, Uray E, Sorantin E, Lindbichler F, Mayr J. Gastroesophageal reflux and diaphragmatic motility after repair of congenital diaphragmatic hernia. European journal of pediatric surgery. 2000;10(06):360-4.
13.Haliburton B, Mouzaki M, Chiang M, Scaini V, Marcon M, Moraes TJ, et al. Long-term nutritional morbidity for congenital diaphragmatic hernia survivors: failure to thrive extends well into childhood and adolescence. Journal of pediatric surgery. 2015;50(5):734-8.