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Maximal oxygen consumption and stress performance in children operated on for congenital diaphragmatic hernia
A Zaccara1, A Turchetta, A Calzolari
1Department of Pediatric Surgery, Bambino Gesú Children's Hospital, Rome, Italy.
Insights
Congenital diaphragmatic hernia (CDH) survivors show lower exercise capacity, but this reflects reduced physical fitness, not respiratory issues. These children can safely engage in competitive sports.
Area of Science:
- Pediatric Surgery
- Exercise Physiology
- Pulmonology
Background:
- Long-term outcomes for congenital diaphragmatic hernia (CDH) patients focus on clinical and respiratory health.
- Limited data exists on the sports participation and exercise performance of individuals with a history of CDH.
Purpose of the Study:
- To evaluate the sports practice and exercise stress performance in children treated for CDH.
- To determine if reduced exercise capacity is linked to respiratory function or overall physical fitness.
Main Methods:
- Exercise stress testing with workload increase and maximal oxygen consumption (Vo2 max) measurement in 15 CDH patients and 15 healthy controls.
- Assessment of dynamic lung volumes, clinical parameters, and lifestyle via questionnaire.
- Comparison of Vo2 max and exercise duration between CDH patients and controls.
Main Results:
- CDH patients reported good lifestyles, but only 8 participated in sports.
- Exercise duration and Vo2 max were significantly lower in CDH patients compared to controls.
- Sedentary CDH patients exhibited the lowest Vo2 max values.
Conclusions:
- Reduced Vo2 max in CDH patients is primarily indicative of lower physical fitness, not impaired respiratory function.
- Children with a history of CDH can likely participate safely in competitive physical activities.
- Promoting sports participation may enhance the overall well-being and fitness of CDH survivors.
Abstract:
The long-term follow-up of patients operated on for congenital diaphragmatic hernia (CDH) at birth has been extensively evaluated, both clinically and with respect to respiratory function. However, little is known about the sports practice and stress performance of these subjects. Fifteen of 107 patients operated on for CDH underwent exercise stress testing with a stepwise increase in workload. A questionnaire was provided, which requested information on sports practice and lifestyle. Maximal oxygen consumption [Vo2 max] was measured along with dynamic lung volumes. Clinical examination included a whole-body assessment (height, weight, skinfolds) and vital parameters (heart rate and blood pressure). Fifteen healthy children who practiced regular physical activity (2 to 4 hours/week) served as controls. All the CDH patients experienced a good lifestyle, but only 8 of them were participating in sports. Exercise duration and Vo2 max were significantly lower for the CDH patients, and were lowest for the sedentary patients. Therefore, the reduced Vo2 max of these otherwise healthy children most likely represents a lower degree of physical fitness rather than decreased respiratory function. Fitness is an expression of well-being; thus, there is evidence that these patients could safely participate in competitive motor activities.