Cardiopulmonary exercise performance is reduced in congenital diaphragmatic hernia survivors

被引:24
作者
Bojanic, Katarina [1 ]
Grizelj, Ruza [2 ]
Dilber, Daniel [3 ]
Saric, Dalibor [3 ]
Vukovic, Jurica [2 ]
Pianosi, Paolo T. [4 ]
Driscoll, David J. [5 ]
Weingarten, Toby N. [6 ]
Pritisanac, Ena [2 ]
Schroeder, Darrell R. [7 ]
Sprung, Juraj [6 ]
机构
[1] Univ Hosp Merkur, Dept Obstet & Gynecol, Div Neonatol, Zagreb, Croatia
[2] Univ Zagreb, Sch Med, Univ Hosp Ctr, Dept Paediat, Zagreb, Croatia
[3] Univ Zagreb, Sch Med, Univ Hosp Ctr, Div Pediat Cardiol, Zagreb, Croatia
[4] Mayo Clin, Dept Pediat & Adolescent Med, Rochester, MN USA
[5] Mayo Clin, Div Pediat Cardiol, Rochester, MN USA
[6] Mayo Clin, Dept Anesthesiol, 200 First St SW, Rochester, MN 55905 USA
[7] Mayo Clin, Div Biomed Stat & Informat, Rochester, MN USA
关键词
cardiopulmonary exercise performance; cardiopulmonary exercise testing; congenital diaphragmatic hernia; maximal exercise capacity; pulmonary function; CARDIORESPIRATORY FUNCTION; PULMONARY MORBIDITY; LUNG-FUNCTION; OPERATION; CAPACITY; PROTOCOL; CHILDREN; ANATOMY; GROWTH;
D O I
10.1002/ppul.23481
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundCongenital 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. MethodsIn one medical center in Croatia, CDH survivorspatients with surgically corrected CDH who were alive at age 5 yearswere 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. ResultsAmong 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 (V mean [SD], 35.7 [6.9] vs. 45.3 [8.2] ml/kg per min; P<0.001). At peak exercise, V/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) (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). ConclusionMore 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 max who may benefit from physical training. Pediatr Pulmonol. 2016;51:1320-1329. (c) 2016 Wiley Periodicals, Inc.
引用
收藏
页码:1320 / 1329
页数:10
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