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Recommended schedule of follow-up for infants with congenital diaphragmatic hernia

Recommended schedule of follow-up for infants with congenital diaphragmatic hernia
  Before discharge 1 to 3 months after birth 4 to 6 months after birth 9 to 12 months after birth 15 to 18 months after birth Annual through 16 years
Weight, length, occipital-frontal circumference X X X X X X
Chest radiograph X If patched If patched If patched If patched If patched
Pulmonary function testing     If indicated   If indicated If indicated
Childhood immunizations As indicated throughout childhood X X X X X
RSV prophylaxis RSV season during first two years after birth (if evidence of chronic lung disease) X X X X X
Echocardiogram and cardiology follow-up X If previously abnormal or if on supplemental oxygen If previously abnormal or if on supplemental oxygen If previously abnormal or if on supplemental oxygen If previously abnormal or if on supplemental oxygen If previously abnormal or if on supplemental oxygen
Head computed tomography or MRI If (1) abnormal finding on head ultrasound; (2) seizures/abnormal neurologic findings*; or (3) ECMO or patch repair As indicated As indicated As indicated As indicated As indicated
Hearing evaluation Auditory brainstem evoked response or otoacoustic emissions screen X X X X Every six months to age three years, then annually to age five years
Developmental screening evaluation X X X X   Annually to age five years
Neurodevelopmental evaluation X     X   Annually to age five years
Assessment for oral feeding problems X X If oral feeding problems If oral feeding problems If oral feeding problems If oral feeding problems
Upper gastrointestinal study, pH probe, and/or gastric scintiscan Consider for all patients If symptoms If symptoms Consider for all patients If symptoms If symptoms
Esophagoscopy   If symptoms If symptoms If symptoms or if abnormal gastrointestinal evaluations If symptoms If symptoms
Scoliosis and chest wall deformity screening (physical examination, chest radiograph, and/or computed tomography of the chest)       X   X
The neurosensory tests performed and frequency of surveillance may differ among infants with CDH because of variability in neurologic, developmental, and physiologic impairments. Follow-up should be tailored to each infant.
RSV: respiratory syncytial virus; ECMO: extracorporeal membrane oxygenation.
* Muscle weakness, hypotonia, hypertonia, or other abnormal neurologic sign or symptom.
Reproduced with permission from Pediatrics, Vol 121, Pages 627-32, Copyright © 2008 by the AAP.
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