title: Determinants of exercise capacity in school-aged esophageal atresia patients.
abstract: 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.
  
  
  
  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.
  
  
  
  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 TLChe-1.06 (1.29); P < 0.001). Diffusion capacity corrected for alveolar volume was normal (mean (SD) SDS KCO-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.
  
  
  
  Eight-year-old children with EA had reduced exercise capacity which was only associated with the reduction in TLCheand 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.
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.|Department of Orthopedics, Section of Physical Therapy, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Leontien C C
authors.initials: LCC
authors.lastname: Toussaint-Duyster
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.|Department of Orthopedics, Section of Physical Therapy, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Monique H M
authors.initials: MHM
authors.lastname: van der Cammen-van Zijp
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Spoel
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Mhanfei
authors.initials: M
authors.lastname: Lam
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Rene M H
authors.initials: RMH
authors.lastname: Wijnen
authors.affiliation: Department of Pediatrics, Division of Pediatric Respiratory Medicine, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.affiliation: Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: van Rosmalen
authors.affiliation: Intensive Care and, Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Hanneke
authors.identifier: 0000-0001-5824-3492
authors.initials: H
authors.lastname: IJsselstijn
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000494:pharmacology; D002648:Child; D004933:Esophageal Atresia / Q000150:complications / Q000503:physiopathology*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D012141:Respiratory Tract Infections / Q000188:drug therapy; D013147:Spirometry; D014109:Total Lung Capacity
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents
keywords: congenital malformations; esophageal atresia; exercise capacity; pulmonary function testing; respiratory tract infections; school-aged children