Respiratory function after repair of congenital diaphragmatic hernia

SUMMARY Respiratory function studies were carried out in 22 infants who had successful repair of diaphragmatic herniae of the Bochdalek type. Thoracic gas volume was initially reduced in only 3 of these, but subsequent studies showed that improvement occurred. There were no consistent abnormalities in either dynamic compliance or mean pulmonary conductance. This is evidence that there is rapid adaptation which compensates for any alteration in the parenchymatous tissue in the lungs or abnormalities in the bronchial tree in infants soon after the repair of congenital diaphrag-matic herniae. Further studies are necessary to determine the changes in these lungs with growth. There is considerable pathological evidence that significant hypoplasia of both lungs is present in infants who die soon after birth with congenital diaphragmatic herniae of the Bochdalek type. However, there have been conflicting reports concerning the type of hypoplasia present. One suggestion bas been that the hypoplasia is predomi-nantly due to a reduction in the number of bronchia