Cardiopulmonary performances in young children and adolescents born with large abdominal wall defects.
OBJECTIVE
As long as the survival rate of patients with abdominal wall defects (AWD) increases, information about long-term follow-up is becoming necessary. Even though quality of life in these patients, in absence of associated anomalies, appears to be unaffected, respiratory impairment soon after birth has been documented; therefore, participation in sports rarely is addressed.


METHODS
Eighteen patients, ranging in age from 7 to 18 years, operated on at birth for large abdominal wall defects (> 4 cm for gastroschisis; >6 cm for omphalocele) were asked to come for a stress test on a treadmill, with measurements of time of exercise (TE), maximal oxygen consumption (VO2 max) and continuous recording of vital parameters. Respiratory function also was assessed by Forced Vital Capacity (FVC).


RESULTS
Ergometric data were compared with those of a normal pediatric population. All patients were able to perform the stress test with no cardiovascular abnormalities detected at rest or on exertion. Maximum heart rate was reached after a significantly shorter TE, and VO2 max was significantly reduced when comparing normal subjects with AWD subjects and AWD subjects in sports with those sedentary. FVC was only slightly reduced in AWD patients without reaching statistical significance.


CONCLUSIONS
These findings indicate that patients operated on for AWD at birth exhibit a normal cardiorespiratory function; decreased TE and VO2 max are likely to reflect a lack of physical activity with a lower degree of fitness. Therefore, no limitations to motor performances should exist for these patients. Well-being may be greatly improved by regular exercise.
Zaccara
A
A
Newborn Surgery, Sports Medicine, and Radiology Units, Bambino Gesù Children's Hospital, Rome, Italy.
Iacobelli
B D
BD
Calzolari
A
A
Turchetta
A
A
Orazi
C
C
Schingo
P
P
Bagolan
P
P
D000293:Adolescent; D002648:Child; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000534:rehabilitation / Q000601:surgery*; D006321:Heart / Q000503:physiopathology*; D006554:Hernia, Umbilical / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010101:Oxygen Consumption; D010809:Physical Fitness; D012189:Retrospective Studies; D014797:Vital Capacity