{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:45:17Z","timestamp":1771476317651,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Congenital diaphragmatic hernia (CDH) survivors are at risk for long\u2010term exercise impairment and pulmonary morbidity, but the generalizability of prior reported cohorts are limited by reduced disease severity and older surgical eras. We assessed the mid\u2010childhood exercise and pulmonary function outcomes in a contemporary cohort of CDH survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>In this retrospective cohort study, we identified 36 consecutive pediatric CDH survivors who underwent cardiopulmonary exercise testing (CPET) and spirometry from 2014 to 2021. Inferential statistics compared survivors with age\u2010, sex\u2010, and size\u2010matched healthy controls; univariate analyses identified factors associated with abnormal testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Maximal effort CPET and resting spirometry were completed by 27\/36 (75%) and 31\/36 (86%) subjects, respectively (median age: 8.1 years [interquartile range: 7.5, 10]; 16 females [44%]). Abnormal CPET (percent predicted [pp] peak VO<jats:sub>2<\/jats:sub>\u2009&lt;\u200980%) was more common in the CDH cohort (12 vs. 1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and associated with longer neonatal intensive care unit (NICU) stay (<jats:italic>p<\/jats:italic>\u2009=\u20090.02) and oxygen therapy at discharge (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Exercise impairment was mild (pp peak VO<jats:sub>2<\/jats:sub> 70%\u201380%), moderate (60%\u201370%), and severe (&lt;60%) in 6, 4, and 2 survivors, respectively. Abnormal spirometry was more common in the CDH cohort (21 vs. 3, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; obstructive [<jats:italic>n<\/jats:italic>\u2009=\u200915], restrictive [<jats:italic>n<\/jats:italic>\u2009=\u20096]) and associated with decreased gestational age (<jats:italic>p<\/jats:italic>\u2009=\u20090.046), longer mechanical ventilation in the NICU (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), and orthopedic abnormalities (<jats:italic>p<\/jats:italic>\u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion(s)<\/jats:title><jats:p>Exercise capacity was normal or mildly impaired in most CDH survivors, however, approximately two\u2010thirds demonstrated abnormal spirometry. Impaired exercise capacity and lung function were associated with severity of lung disease postnatally. These data support cardiopulmonary follow\u2010up throughout childhood.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26348","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T06:06:19Z","timestamp":1675836379000},"page":"1471-1480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term exercise and pulmonary function outcomes in a contemporary cohort of children with congenital diaphragmatic hernia"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-4384","authenticated-orcid":false,"given":"Kimberley G.","family":"Miles","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam W.","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of 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