Cardiopulmonary exercise performance is reduced in congenital diaphragmatic hernia survivors

Katarina Bojanić, Ruža Grizelj, Daniel Dilber, Dalibor Šarić, Jurica Vuković, Paolo T. Pianosi, David J. Driscoll, Toby N. Weingarten, Ena Pritišanac, Darrell R. Schroeder, Juraj Sprung

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: Congenital diaphragmatic hernia (CDH) is associated with lung hypoplasia. CDH survivors may have pulmonary morbidity that can decrease cardiopulmonary exercise. We aimed to examine whether cardiopulmonary exercise testing (CPET) results differ in CDH survivors versus healthy age-matched controls and whether CPET results among CDH survivors differ according to self-reported daily activity. Methods: In one medical center in Croatia, CDH survivors—patients with surgically corrected CDH who were alive at age 5 years—were invited to participate in spirometry and CPET. Values were compared with those of controls matched 2:1 by age and sex for each CDH survivor aged 7 years or older. Results: Among 27 CDH survivors aged 5–20 years, 13 (48%) had continued symptoms or spirometric evidence of pulmonary disease. Compared with controls (n = 44), survivors (n = 22) had lower peak oxygen consumption (VO2 mean [SD], 35.7 [6.9] vs. 45.3 [8.2] ml/kg per min; P < 0.001). At peak exercise, VO2 /heart rate (P < 0.001), tidal volume (P = 0.005), and minute ventilation (P < 0.001) were lower in survivors, but the maximal respiratory rate was not different (P = 0.72). Among survivors, mean (SD) VO2peak (ml/kg per min) differed by self-reported activity level: athletic, 40.3 (5.0); normal, 35.8 (6.5); and sedentary, 32.1 (6.8) (by ANOVA, P = 0.10 across three groups and P = 0.04 athletic vs. sedentary). Conclusion: More than half of CDH survivors continue to have chronic pulmonary disease. CDH survivors had lower aerobic exercise capacity than controls. Self-reporting information on daily activities may identify CDH patients with low VO2max who may benefit from physical training. Pediatr Pulmonol. 2016;51:1320–1329.

Original languageEnglish (US)
Pages (from-to)1320-1329
Number of pages10
JournalPediatric pulmonology
Issue number12
StatePublished - Dec 1 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 Wiley Periodicals, Inc.


  • cardiopulmonary exercise performance
  • cardiopulmonary exercise testing
  • congenital diaphragmatic hernia
  • maximal exercise capacity
  • pulmonary function


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