Feasibility of Hypoxic Challenge Testing in Children and Adolescents with Congenital Heart and Lung Disease.
BACKGROUND
This is a cross-sectional observational study to investigate the safety and feasibility of integrating changing body positions and physical activity in a hypoxic challenge test (HCT). The secondary objective was to compare oxygen saturation (Spo2) in two different locations (forehead and finger).


METHODS
Included were 12 pediatric to young adult patients with congenital heart (N = 7) or lung disease (N = 5). An HCT was performed using breathing room air (21% oxygen) while sitting and breathing a normobaric hypoxic gas mixture (15% oxygen) through a facemask while seated, lying supine, standing, walking 3 km/h, and walking 5 km/h in a nonrandomized order.


RESULTS
All patients, except one, successfully passed the HCT. Three patients reported symptoms, possibly related to hypoxia. Median Spo2 during the HCT decreased in all body positions compared with room air. In 9/12 (finger oximeter) vs. 6/12 (forehead oximeter) patients Spo2 decreased below 90% in one or more body positions at rest. In 11/12 (finger oximeter) vs. 3/12 (forehead oximeter) patients Spo2 decreased below 90% during mild exercise. There was no significant difference in Spo2 between the different body positions. However, patients desaturated significantly more during mild exercise (walking 3km/h and 5 km/h). Spo2% measured at the forehead gave significantly higher values compared to the index finger.


CONCLUSIONS
HCT is safe and feasible in children and adolescents with congenital heart or lung disease, and gives additional information about oxygenation during physical activity in addition to resting conditions. Simulated hypoxia of 8202 ft (2500 m) induced a small but significant decrease in Spo2%.Spoorenberg ME, Hulzebos EHJ, Takken T. Feasibility of hypoxic challenge testing in children and adolescents with congenital heart and lung disease. Aerosp Med Hum Perform. 2016; 87(12):1004-1009.
Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht,The Netherlands.
Mandy E
ME
Spoorenberg
Erik H J
EH
Hulzebos
Tim
T
Takken
D000293:Adolescent; D000337:Aerospace Medicine; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000378:metabolism*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D005385:Fingers; D005546:Forehead; D006330:Heart Defects, Congenital / Q000378:metabolism*; D006801:Humans; D000860:Hypoxia / Q000378:metabolism*; D008171:Lung Diseases / Q000151:congenital / Q000378:metabolism; D008297:Male; D009584:Nitrogen / Q000494:pharmacology; D010092:Oximetry; D010100:Oxygen / Q000494:pharmacology; D010313:Partial Pressure; D010865:Pilot Projects; D011187:Posture
C041364:nitrox; D009584:Nitrogen; D010100:Oxygen