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Published on: August 24, 2019
Exercise capacity in children with bronchopulmonary dysplasia at school age
Freerk Prenzel1, Mandy Vogel2, Werner Siekmeyer1
1University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
Insights
Children with bronchopulmonary dysplasia (BPD) experience reduced exercise capacity and lung function at school age. They also report more exercise-related respiratory symptoms compared to healthy peers.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Neonatology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Long-term effects of BPD on exercise capacity and lung function at school age are not fully understood.
Purpose of the Study:
- To compare exercise capacity, exercise habits, and lung function in school-aged children with BPD versus term-born controls.
- To identify potential exercise limitations and respiratory symptoms in children with BPD.
Main Methods:
- Cardiopulmonary exercise testing (CPET) and pulmonary function tests were conducted in 42 children with BPD and 42 controls.
- Questionnaires assessed daily activity, sports participation, and respiratory symptoms.
Main Results:
- Children with BPD demonstrated significantly lower peak exercise oxygen consumption, minute ventilation, and workload compared to controls.
- Reduced forced expiratory volume in 1 second and expiratory flow were observed in the BPD group.
- Children with BPD reported increased difficulties with physical activity and exercise-induced wheezing or shortness of breath.
Conclusions:
- School-aged children with BPD exhibit airflow obstruction and reduced exercise capacity.
- They experience more respiratory symptoms during physical activity.
- Weight-adjusted oxygen consumption suggests preserved alveolar function despite airflow limitations.
Objective:
To assess the exercise capacity, exercise habits, and lung function of preterm born children with bronchopulmonary dysplasia (BPD) compared to term born controls at school age.
Methods:
Cardiopulmonary exercise test (CPET) by cycle ergometer and pulmonary function test were performed in children with BPD (n = 42) and compared with a term born control group (n = 42). Daily activity, participation in sports and respiratory symptoms were assessed by questionnaire.
Results:
Children with BPD versus controls had significantly lower values for oxygen consumption (V̇O2 [mL/min] 1442 ± 417 vs. 1766 ± 541), minute ventilation (VE [L/min] 48 ± 14.92 vs. 60 ± 18.33), and workload (W [watt] 96.1 ± 16.7 vs. 110.6 ± 17.2) at peak exercise and a lower anaerobic threshold (VO2 AT [mL/min] 1183 ± 345 vs. 1382 ± 398). When corrected for weight, only for the workload (2.7 ± 0.5 vs. 3.1 ± 0.5, p = 0.0013) did significant differences persist. The forced expiratory volume in 1 s and forced expiratory flow between 25 and 75% of expired forced vital capacity were significantly reduced in the BPD group (p < 0.0001). Children with BPD have a higher risk of reporting difficulties in physical activity (OR 2.5) and of suffering from wheezing or shortness of breath while exercising (OR 2.5).
Conclusion:
Compared to term born controls, children with BPD at school age show airflow obstruction, a lower workload in CPET, and more respiratory symptoms related to physical activity. The comparable oxygen consumption based on weight suggests a functionally normal alveolar compartment.
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