Long-term nutritional morbidity for congenital diaphragmatic hernia survivors: Failure to thrive extends well into childhood and adolescence

Journal of Pediatric Surgery
Beth HaliburtonPriscilla P Chiu

Abstract

Failure to thrive (FTT) is well documented among congenital diaphragmatic hernia (CDH) survivors ≤3years of age, but its etiology, severity, and persistence beyond this age require further elucidation. We conducted a single-center, retrospective study assessing anthropometrics, measured energy expenditure, and feeding tube (FT) use of 5-17 year olds in our multidisciplinary CDH clinic since January 2001. We stratified clinic visits based on age A: 5.0-6.9, B: 7.0-9.9, C: 10.0-14.9, and D: 15-17.9years. One hundred sixteen patients with 376 outpatient visits were reviewed. Anthropometric z-scores were below zero and did not vary across age cohorts. FTT and growth stunting each occurred in 14% of clinic visits. FTs inserted during infancy occurred in 25% of patients, and 60% remained by age 7years. In cohort A, those with FTs were lighter and shorter than those without (p<0.05) but had similar BMIs. FTT incidence was higher in the FT group (p=0.020), but FTs were present in only 30% of those with FTT. Indirect calorimetry revealed increased energy expenditure in 58% of patients. Failure to thrive continues in long-term CDH survivors, FTs may not improve incidence of FTT. Increased energy expenditure may play a role.

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Citations

Mar 5, 2016·Journal of Pediatric Surgery·Sebastian K KingPriscilla P L Chiu
Sep 21, 2010·Journal of Pediatric Surgery·Tim JancelewiczKerilyn K Nobuhara
May 11, 2017·Journal of Pediatric Gastroenterology and Nutrition·Lan T VuHanmin Lee
Oct 16, 2015·Journal of Pediatric Gastroenterology and Nutrition·Beth HaliburtonMarialena Mouzaki
Jul 6, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Jennifer R BathgateKarna Murthy
Feb 27, 2021·Pediatric Pulmonology·Sahar Al BaroudiEric B Jelin
Mar 29, 2021·Journal of Pediatric Surgery·Hannah FlemingJason Gien
Apr 24, 2021·Journal of Pediatric Surgery·K Taylor WildUrsula S Nawab
Jul 25, 2021·BMJ Case Reports·Kevin C McGannMichael H Livingston
Jul 21, 2021·Journal of Pediatric Surgery·Francesca LandolfoFrancesco Morini
Jun 13, 2021·Journal of Pediatric Gastroenterology and Nutrition·Marisa E SchwabLan T Vu
Oct 29, 2017·Journal of Pediatric Surgery·Ryan M AntielHolly L Hedrick

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