Exploring Dysphagia in Congenital Diaphragmatic Hernia: A Retrospective Analysis.

Background

Congenital diaphragmatic hernia (CDH) is a complex congenital disorder often accompanied by long-term feeding difficulties. There is a paucity of published data regarding the impact of swallowing difficulties on long-term patient outcomes. Our study attempts to evaluate this phenomenon.

Methods

A retrospective chart review of infants born with CDH between 2021 and 2022 identified 45 patients. The following variables were identified: need for swallow study, stomach location, defect type, need for anti-reflux therapy, need for nasogastric tube (NG) or gastric tube (GT) at time of discharge, poor growth, and frequency of respiratory infections during the first 12 months of life.

Results

Thirty-one percent of patients (n = 14) underwent a swallow study, 20% (n = 9) required long-term anti-reflux medications, 18% (n = 8) had a GT and 59% (n = 26) had an NG in place at time of discharge, 44% (n = 17) experienced poor growth as an outpatient, and 35% (n = 16) had respiratory infections in the first 12 months of life requiring hospitalization. Infants with a Type D defect commonly required GT at discharge (40%), experienced respiratory infections in the first 12 months (67%), and had poor growth as an outpatient (67%).

Conclusions

Our findings underscore the need for routine dysphagia screening in CDH infants during NICU admission. Differences in outcomes based on defect type suggest that early identification and targeted interventions for feeding and swallowing issues may improve long-term growth and respiratory outcomes for CDH patients. Further studies are warranted to develop standardized dysphagia management guidelines for this population.