Improvement of exercise capacity following neonatal respiratory failure: A randomized controlled trial

Area of Science:

• Pediatric cardiology
• Exercise physiology
• Congenital anomalies

Background:

• Children with major anatomical foregut anomalies or treated with extracorporeal membrane oxygenation (ECMO) often exhibit reduced exercise capacity.
• Understanding factors influencing exercise capacity in this population is crucial for effective management.

Purpose of the Study:

• To evaluate the short-term and long-term effects of standardized anaerobic high-intensity interval training (HIIT) and/or online lifestyle coaching on exercise capacity in children with anatomical foregut anomalies and/or ECMO treatment.
• To compare these interventions against standard care.

Main Methods:

• A single-blinded randomized controlled trial involving 40 participants.
• Participants were assigned to three groups: HIIT plus lifestyle coaching, lifestyle coaching only, or standard care.
• Exercise capacity was assessed using the Bruce protocol at baseline, 3 months, and 12 months.

Main Results:

• Exercise capacity significantly improved over the 12-month study period across all groups (P < .001).
• No significant differences in maximal endurance time were observed between the intervention groups (HIIT + coaching, coaching only) and the standard care group at 3 or 12 months.
• Improvements in exercise capacity occurred irrespective of the specific intervention received.

Conclusions:

• Exercise capacity can improve over time in children with anatomical foregut anomalies and/or ECMO treatment, independent of specific exercise or coaching interventions.
• Factors beyond residual morbidities, such as parental awareness and lifestyle counseling, may play a significant role.
• Routine monitoring of exercise tolerance and individualized lifestyle counseling are recommended for this patient group.