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Factors limiting exercise performance in long-term survivors of bronchopulmonary dysplasia
P Santuz1, E Baraldi, P Zaramella
1Department of Pediatrics, University of Padova School of Medicine, Italy.
Insights
Children with bronchopulmonary dysplasia (BPD) exhibit long-term exercise limitations, including reduced pulmonary function and oxygen saturation during exertion. These findings highlight the persistent impact of BPD on respiratory health in childhood.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Neonatology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease resulting from premature birth.
- Long-term pulmonary sequelae of BPD can affect exercise capacity in children.
- Understanding exercise impairment is crucial for managing BPD survivors.
Purpose of the Study:
- To assess long-term pulmonary function during exercise in children with a history of BPD.
- To compare exercise performance between children with BPD and healthy controls.
- To identify specific physiological limitations during exertion in BPD survivors.
Main Methods:
- Pulmonary function tests at rest and during maximal treadmill exercise.
- Monitoring of oxygen consumption (VO2), carbon dioxide output (VCO2), and minute ventilation (VE).
- Comparison of spirometry, arterial oxygen saturation (SaO2), FEV1 fall, VO2, VE, and anaerobic threshold between BPD children and controls.
Main Results:
- Children with BPD showed lower baseline spirometry values and a greater post-exercise FEV1 fall compared to controls.
- Peak exercise SaO2 decreased in 4 BPD children, indicating exercise-induced hypoxemia.
- Significantly lower maximum VO2, VE, and anaerobic threshold were observed in the BPD group, with a ventilatory pattern of lower tidal volumes.
Conclusions:
- Children with BPD experience significant long-term impairment in pulmonary function during exercise.
- Exercise limitation in BPD survivors is characterized by reduced aerobic capacity and ventilatory inefficiency.
- These findings underscore the need for targeted interventions to improve exercise tolerance in BPD patients.
Abstract:
The long-term impairment of pulmonary function during exercise was assessed in 12 children, aged 6 to 12 yr, who developed BPD after prematurity (gestational age 30 +/- 2 wk [mean +/- SD] and birth weight 1,400 +/- 335 g) and 16 age-, sex-, and physical activity-matched healthy children born at term, who served as controls. The children performed pulmonary function tests at rest and a maximal stepwise exercise on a treadmill. Oxygen consumption (VO2), carbon dioxide output (VCO2), and minute ventilation (VE) were monitored during the run. Baseline mean spirometric values (% of predicted) were in the normal range for both groups but were lower in BPD children with respect to control children (p < 0.05). At rest, arterial oxygen saturation (SaO2) was > or = 98% in all BPD children, but at peak exercise, 4 of them had a SaO2 fall > or = 4%. The postexercise FEV1 fall, with respect to the baseline, was 8 +/- 6%, in BPD and 2 +/- 1% in control children (p < 0.01). Maximum VO2 and VE were significantly lower in BPD children with respect to the control group (25.2 +/- 10.3 versus 37.1 +/- 10.4 ml/min/kg and 20.8 +/- 9.4 versus 30.7 +/- 7.9 L/min, respectively, both p < 0.01). Also, at submaximal levels of exercise dynamic, VO2 and VE responses were significantly lower in the BPD group (ANOVA, p < 0.001), with a ventilatory pattern characterized by lower tidal volumes. Anaerobic threshold was 20.6 +/- 9 in BPD and 28.8 +/- 8.6 ml O2/min/kg in healthy children (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)