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Physical exercise effect on certain acid-base equilibrium parameters in children with small ventricular septal
Insights
Children with ventricular septum defects experience metabolic acidosis more readily during physical exercise compared to healthy peers. This effect is more pronounced with increased exercise intensity.
Area of Science:
- Pediatric Cardiology
- Exercise Physiology
- Biochemistry
Background:
- Ventricular septum defects (VSDs) are common congenital heart abnormalities.
- Understanding the physiological responses to exercise in children with VSDs is crucial for management.
- Acid-base balance during exertion is a key indicator of cardiovascular and metabolic function.
Purpose of the Study:
- To investigate acid-base equilibrium in children with VSDs during varying physical exercise intensities.
- To compare the exercise-induced metabolic and respiratory responses between children with VSDs and healthy controls.
Main Methods:
- Studied 47 children (7-16 years): 28 with VSDs and 19 healthy controls.
- Measured blood pH, base excess (BE), and pCO2 using Astrup microapparatus on arterialized capillary blood.
- Assessed acid-base parameters during three exercise levels: normal locomotion, moderate (170-180 bpm), and high intensity (190 bpm).
Main Results:
- Children with VSDs showed a significantly greater tendency towards metabolic acidosis during all exercise workloads compared to controls.
- The difference in metabolic acidosis was more pronounced in children with VSDs during high-intensity exercise versus lower intensities.
- Respiratory parameters also showed differences, though the primary finding related to metabolic changes.
Conclusions:
- Children with small VSDs exhibit impaired metabolic compensation during physical exertion.
- Exercise testing can reveal subclinical metabolic disturbances in pediatric cardiac patients.
- These findings highlight the importance of considering exercise capacity and acid-base status in VSD management.
Abstract:
Forty-seven children aged from 7 to 16 years were studied: 28 children had small ventricular septum defects and 19 healthy children served as controls. The following acid-base equilibrium parameters were determined in all children: pH, BE, pCO2, metabolic pH and respiratory pH in the arterialized capillary blood taken from the fingertip using an Astrup microapparatus. The determinations were made during three types of physical exercise: normal everyday locomotion and graded exercise raising the heart rate to about 170-180/min and about 190/min. The intensity of the exercise in the step test was calculated from the formula of Nikodemowicz. It was found that metabolic acidosis during these three exercise workloads developed significantly more easily in the children with septum defect than in healthy controls. The same differences were observed in the children with septum defect during the most intense exercise in relation to the exercise of lower intensity.