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Cardiopulmonary performances in young children and adolescents born with large abdominal wall defects
A Zaccara1, B D Iacobelli, A Calzolari
1Newborn Surgery, Sports Medicine, and Radiology Units, Bambino Gesù Children's Hospital, Rome, Italy.
Insights
Patients with abdominal wall defects (AWD) show normal cardiorespiratory function but reduced exercise capacity, likely due to lower fitness levels. Regular exercise can improve well-being and physical performance in these individuals.
Area of Science:
- Pediatric Cardiology
- Pulmonology
- Sports Medicine
Background:
- Increasing survival rates for abdominal wall defects (AWD) necessitate long-term follow-up data.
- While quality of life is generally unaffected in AWD patients without anomalies, early respiratory issues are noted.
- Participation in sports is rarely addressed in the long-term care of AWD patients.
Purpose of the Study:
- To assess the long-term cardiorespiratory function and exercise capacity in pediatric patients operated on for large abdominal wall defects.
- To evaluate the impact of physical activity levels on the fitness of these patients.
- To determine if there are limitations to motor performance for individuals with a history of AWD.
Main Methods:
- Eighteen patients (ages 7-18) who underwent surgery for large AWD (gastroschisis >4cm, omphalocele >6cm) participated.
- Treadmill stress tests were conducted, measuring time of exercise (TE) and maximal oxygen consumption (VO2 max).
- Cardiovascular vital signs and respiratory function (Forced Vital Capacity - FVC) were continuously monitored.
Main Results:
- All AWD patients completed the stress test without adverse cardiovascular events.
- Compared to healthy controls, AWD patients demonstrated significantly shorter TE and reduced VO2 max.
- VO2 max was lower in AWD patients who were sedentary compared to those who participated in sports.
- FVC was only slightly reduced in AWD patients, not reaching statistical significance.
Conclusions:
- Patients operated on for AWD exhibit normal cardiorespiratory function at rest and during exertion.
- Reduced exercise capacity (TE and VO2 max) is likely linked to lower physical activity and fitness, not underlying pathology.
- No inherent limitations to motor performance are expected for AWD patients.
- Regular physical activity and exercise are recommended to improve fitness and overall well-being.
Background/Purpose:
As long as the survival rate of patients with abdominal wall defects (AWD) increases, information about long-term follow-up is becoming necessary. Even though quality of life in these patients, in absence of associated anomalies, appears to be unaffected, respiratory impairment soon after birth has been documented; therefore, participation in sports rarely is addressed.
Methods:
Eighteen patients, ranging in age from 7 to 18 years, operated on at birth for large abdominal wall defects (> 4 cm for gastroschisis; >6 cm for omphalocele) were asked to come for a stress test on a treadmill, with measurements of time of exercise (TE), maximal oxygen consumption (VO2 max) and continuous recording of vital parameters. Respiratory function also was assessed by Forced Vital Capacity (FVC).
Results:
Ergometric data were compared with those of a normal pediatric population. All patients were able to perform the stress test with no cardiovascular abnormalities detected at rest or on exertion. Maximum heart rate was reached after a significantly shorter TE, and VO2 max was significantly reduced when comparing normal subjects with AWD subjects and AWD subjects in sports with those sedentary. FVC was only slightly reduced in AWD patients without reaching statistical significance.
Conclusions:
These findings indicate that patients operated on for AWD at birth exhibit a normal cardiorespiratory function; decreased TE and VO2 max are likely to reflect a lack of physical activity with a lower degree of fitness. Therefore, no limitations to motor performances should exist for these patients. Well-being may be greatly improved by regular exercise.