Children with Burn Injury Have Impaired Cardiac Output during Submaximal Exercise

Eric Rivas, David Herndon, Kenneth C. Beck, Oscar Suman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

INTRODUCTION: Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output (Q) and stroke volume (SV) during submaximal exercise. METHODS: Five children with 49±4% total body surface area (BSA) burned (2 female, 11.7±1 y, 40.4±18 kg, 141.1±9 cm) and eight similar non-burned controls (5 female, 12.5±2 y, 58.0±17 kg, 147.3±12 cm) with comparable exercise capacity (peak oxygen consumption [peak VO2]: 31.9±11 vs. 36.8±8 ml O2·kg·min, P=0.39) participated. The exercise protocol entailed a pre-exercise (pre-EX) rest period followed by 3-minute exercise stages at 20 W and 50 W. VO2, heart rate (HR), Q (via non-rebreathing), SV (Q/HR), and arteriovenous O2 difference ([a-v] O2 dif, Q/VO2) were the primary outcome variables. RESULTS: Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that Q was ~27% lower in the burned than the non-burned group at 20 W of exercise (burned 5.7±1.0 vs. nonburned: 7.9±1.8 L·min) and 50 W of exercise (burned 6.9±1.6 vs. nonburned 9.2 ±3.2 L·min) (G × EX interaction, P=0.012). SV did not change from rest to exercise in burned children but increased by ~24% in the non-burned group (main effect for EX, P=0.046). Neither [a-v] O2 dif nor VO2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G × EX interaction, P=0.004). When normalized to BSA, SV (index) was similar between groups; however, Q (index) remained attenuated in the burned group (G × EX interaction, P<0.008). CONCLUSIONS: Burned children have an attenuated cardiovascular response to submaximal exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.

Original languageEnglish (US)
JournalMedicine and Science in Sports and Exercise
DOIs
StateAccepted/In press - May 22 2017

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Cardiac Output
Exercise
Wounds and Injuries
Stroke Volume
Heart Rate
Body Surface Area
Oxygen Consumption

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Children with Burn Injury Have Impaired Cardiac Output during Submaximal Exercise. / Rivas, Eric; Herndon, David; Beck, Kenneth C.; Suman, Oscar.

In: Medicine and Science in Sports and Exercise, 22.05.2017.

Research output: Contribution to journalArticle

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title = "Children with Burn Injury Have Impaired Cardiac Output during Submaximal Exercise",
abstract = "INTRODUCTION: Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output (Q) and stroke volume (SV) during submaximal exercise. METHODS: Five children with 49±4{\%} total body surface area (BSA) burned (2 female, 11.7±1 y, 40.4±18 kg, 141.1±9 cm) and eight similar non-burned controls (5 female, 12.5±2 y, 58.0±17 kg, 147.3±12 cm) with comparable exercise capacity (peak oxygen consumption [peak VO2]: 31.9±11 vs. 36.8±8 ml O2·kg·min, P=0.39) participated. The exercise protocol entailed a pre-exercise (pre-EX) rest period followed by 3-minute exercise stages at 20 W and 50 W. VO2, heart rate (HR), Q (via non-rebreathing), SV (Q/HR), and arteriovenous O2 difference ([a-v] O2 dif, Q/VO2) were the primary outcome variables. RESULTS: Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that Q was ~27{\%} lower in the burned than the non-burned group at 20 W of exercise (burned 5.7±1.0 vs. nonburned: 7.9±1.8 L·min) and 50 W of exercise (burned 6.9±1.6 vs. nonburned 9.2 ±3.2 L·min) (G × EX interaction, P=0.012). SV did not change from rest to exercise in burned children but increased by ~24{\%} in the non-burned group (main effect for EX, P=0.046). Neither [a-v] O2 dif nor VO2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G × EX interaction, P=0.004). When normalized to BSA, SV (index) was similar between groups; however, Q (index) remained attenuated in the burned group (G × EX interaction, P<0.008). CONCLUSIONS: Burned children have an attenuated cardiovascular response to submaximal exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.",
author = "Eric Rivas and David Herndon and Beck, {Kenneth C.} and Oscar Suman",
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AU - Suman, Oscar

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N2 - INTRODUCTION: Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output (Q) and stroke volume (SV) during submaximal exercise. METHODS: Five children with 49±4% total body surface area (BSA) burned (2 female, 11.7±1 y, 40.4±18 kg, 141.1±9 cm) and eight similar non-burned controls (5 female, 12.5±2 y, 58.0±17 kg, 147.3±12 cm) with comparable exercise capacity (peak oxygen consumption [peak VO2]: 31.9±11 vs. 36.8±8 ml O2·kg·min, P=0.39) participated. The exercise protocol entailed a pre-exercise (pre-EX) rest period followed by 3-minute exercise stages at 20 W and 50 W. VO2, heart rate (HR), Q (via non-rebreathing), SV (Q/HR), and arteriovenous O2 difference ([a-v] O2 dif, Q/VO2) were the primary outcome variables. RESULTS: Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that Q was ~27% lower in the burned than the non-burned group at 20 W of exercise (burned 5.7±1.0 vs. nonburned: 7.9±1.8 L·min) and 50 W of exercise (burned 6.9±1.6 vs. nonburned 9.2 ±3.2 L·min) (G × EX interaction, P=0.012). SV did not change from rest to exercise in burned children but increased by ~24% in the non-burned group (main effect for EX, P=0.046). Neither [a-v] O2 dif nor VO2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G × EX interaction, P=0.004). When normalized to BSA, SV (index) was similar between groups; however, Q (index) remained attenuated in the burned group (G × EX interaction, P<0.008). CONCLUSIONS: Burned children have an attenuated cardiovascular response to submaximal exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.

AB - INTRODUCTION: Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output (Q) and stroke volume (SV) during submaximal exercise. METHODS: Five children with 49±4% total body surface area (BSA) burned (2 female, 11.7±1 y, 40.4±18 kg, 141.1±9 cm) and eight similar non-burned controls (5 female, 12.5±2 y, 58.0±17 kg, 147.3±12 cm) with comparable exercise capacity (peak oxygen consumption [peak VO2]: 31.9±11 vs. 36.8±8 ml O2·kg·min, P=0.39) participated. The exercise protocol entailed a pre-exercise (pre-EX) rest period followed by 3-minute exercise stages at 20 W and 50 W. VO2, heart rate (HR), Q (via non-rebreathing), SV (Q/HR), and arteriovenous O2 difference ([a-v] O2 dif, Q/VO2) were the primary outcome variables. RESULTS: Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that Q was ~27% lower in the burned than the non-burned group at 20 W of exercise (burned 5.7±1.0 vs. nonburned: 7.9±1.8 L·min) and 50 W of exercise (burned 6.9±1.6 vs. nonburned 9.2 ±3.2 L·min) (G × EX interaction, P=0.012). SV did not change from rest to exercise in burned children but increased by ~24% in the non-burned group (main effect for EX, P=0.046). Neither [a-v] O2 dif nor VO2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G × EX interaction, P=0.004). When normalized to BSA, SV (index) was similar between groups; however, Q (index) remained attenuated in the burned group (G × EX interaction, P<0.008). CONCLUSIONS: Burned children have an attenuated cardiovascular response to submaximal exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.

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