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Determinants of exercise capacity in school‐aged esophageal atresia patients
Author(s) -
ToussaintDuyster Leontien C. C.,
van der Cammenvan Zijp Monique H. M.,
Spoel Marjolein,
Lam Mhanfei,
Wijnen Rene M. H.,
de Jongste Johan C.,
Tibboel Dick,
van Rosmalen Joost,
IJsselstijn Hanneke
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23687
Subject(s) - medicine , lung volumes , atresia , respiratory tract , diffusing capacity , ventilation (architecture) , respiratory system , gastroenterology , lung , cardiology , lung function , mechanical engineering , engineering
Abstract BACKGROUND AND AIMS Data on long‐term outcome of exercise capacity in school‐aged children with esophageal atresia (EA) are scarce. We evaluated maximal exercise capacity and its relation to lung function. Moreover, we studied other possible determinants of exercise capacity and lung function. METHODS Exercise capacity of 63 children with EA born 1999‐2007 was evaluated at the age of 8 years with the Bruce‐protocol. Dynamic and static lung volumes, bronchodilator response and diffusion capacity were measured. Furthermore, perinatal characteristics, hospital admissions for lower respiratory tract infections (RTIs), RTIs treated with antibiotics in the past year, symptoms of gastroesophageal reflux, weight‐for‐height, and sports participation were evaluated as other potential determinants. RESULTS Exercise capacity was significantly below normal: mean (SD) SDS −0.91 (0.97); P < 0.001. All spirometric parameters were significantly below normal with significant reversibility of airflow obstruction in 13.5% of patients. Static lung volumes were significantly decreased (mean (SD) SDS TLC he −1.06 (1.29); P < 0.001). Diffusion capacity corrected for alveolar volume was normal (mean (SD) SDS K CO −0.12 (1.04)). Exercise capacity was positively associated with total lung capacity and negatively with SDS weight‐for‐height. Spirometric parameters were negatively associated with congenital cardiac malformation, duration of ventilation, and persistent respiratory morbidity. CONCLUSION Eight‐year‐old children with EA had reduced exercise capacity which was only associated with the reduction in TLC he and higher SDS weight‐for‐height. We speculate that diminished physical activity with recurrent respiratory tract infections may also play a role in reduced exercise capacity. This should be subject to further research to optimize appropriate intervention.