Abstract
Godfrey and Mearns have shown that exercise intolerance in children with C.F. is related to airway obstruction. Recently Campbell et al suggested that poor nutrition leads to abnormal serum lipids which may lead to tissue hypoxia. Our study investigated the roles of hypoxia, lung mechanics, nutritional status and serum lipids in limiting exercise tolerance. Twenty children with C.F. of varying severity performed two progressive exercise tests on a cycle ergometer, once breathing air, once 02. The body mass percentile,(EMP), as a measure of appropriateness of weight for height, was calculated from the body mass index.Serum lipids, maximal mid-expiratory flow rate (MMF) and maximum voluntary ventilation were measured. In five, end tidal CO2 (PETCO2) was monitored throughout the test. 02 had very little effect on the work accomplished by each child. The mean percent work expected from height (Wmax) was 75 and the heart rate at the final work load was 175/min.,20 less in normal children suggesting adequate cardiovascular reserve at the final work load. Wmax correlated with the MMF,the BMP and the Shwachman score. The children with the lower MMF's had little respiratory reserve at the final work load. Despite this,no child at any time had an elevated PETCO2. Serum lipids,while abnormal in every case,did not correlate with any parameter measured.We conclude that nutritional status and airway obstruction are closely correlated with exercise tolerance in C.F. and that,unlike the adult with chronic disease,exercise limiting dyspnea occurs with a normal PETCO2.
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Coates, A., Muller, D., Mearns, M. et al. 1171 FACTORS LIMITING EXERCISE TOLERANCE IN CHILDREN WITH CYSTIC FIBROSIS (C.F.). Pediatr Res 12 (Suppl 4), 559 (1978). https://doi.org/10.1203/00006450-197804001-01177
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DOI: https://doi.org/10.1203/00006450-197804001-01177