Clinical application

1
Clinical application

• Dx exercise intolerance
• 1.1 ? VO2max ? ? VO2 AT
• 1.2 RER gt1.2 (HRmax is not achieved)
• 1.3 ? breathing reserve lt 20 (N20-40)
• 1.4 ? SaO2
• 1.5 VE/VO2 (ventilatory equivalent for oxygen) gt
  40
• Dx exercise-induced bronchospasm (EIB)
• Aerobic fitness evaluation

2
Research study

• Optimal level of physical activity in children
  and adolescent with chronic lung disease

3
Objectives

• To study the optimal level of physical activity
  in children and adolescents with CLD

4
Experimental design
Normal (n18)
CLD (n18)
Hx PE
VO2 at AT ? correlate with physical activity
PFT - Spirometry - Lung volumes - DLco
Exercise stress test
5
Results
Chronic lung diseases

• - Chronic interstitial lung 1
• - Post lobectomy 5
• - Pulmonary hemosiderosis 1
• - Fibrotic lung 3
• - BPD 2
• - Asthma moderate persistent 6

6
Abnormal PFT

• Obstructive lung 7 (FEV1 80.0 12.9pred)
• Restrictive lung 7 (TLC 63.7 12.5pred)
• Diffusion defect 1 (DLco/VA 77 pred)
• Hyperinflation 9 (RV/TLC 38.9 6.5pred)

7
CLD (n 18) Control (n 18) P
FVC 77.3 22.6 97.9 12.5 0.002
FEV1 74.3 17.6 104.0 12.6 lt 0.001
FEV1/FVC 83.4 12.7 90.1 3.8 0.047
FEF25-75 49.9 23.1 75.6 18.6 0.001
TLC 82.8 18.6 95.6 9.8 0.015
RV/TLC 30.8 10.2 24.4 5.9 0.027
DLco/VA 113.2 27.3 109.1 30.3 0.671