TY - JOUR
T1 - Estimated versus achieved maximal oxygen consumption in severely burned children maximal oxygen consumption in burned children
AU - Tapking, Christian
AU - Popp, Daniel
AU - Herndon, David N.
AU - Branski, Ludwik K.
AU - Mlcak, Ronald P.
AU - Suman, Oscar E.
N1 - Funding Information:
We would like to thank Shauna Glover and Ileanna Gutierrez for their work with the children in the Wellness Center. We thank Dr. Kasie Cole-Edwards for editing and proofreading this manuscript.
Funding Information:
The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. This study was supported, at least in part, by awards from the National Institute on Disability, Independent Living, and Rehabilitation Research (90DPBU0003, 90DP0043), National Institutes of Health (R01 HD49071, P50 GM060338, T32 GM8256), the Department of Defense and the American Burn Association (W81XWH-09-2-0194, W81XWH-14-2-0160), and Shriners Hospitals for Children (84080). The content is solely the responsibility of the authors and does not necessarily represent the official views of these agencies or do not necessarily represent the policy of these agencies.
Publisher Copyright:
© 2018
PY - 2018/12
Y1 - 2018/12
N2 - Purpose: In burned children, exercise training increases maximal oxygen consumption (VO2 max) and can be combined with the nonspecific beta-blocker propranolol to decrease cardiac work. VO2 max is estimated if indirect calorimetry is not available. We compared measured and estimated VO2 max in severely burned children treated with or without propranolol to determine the suitability of commonly used formulas in these populations. Methods: Patients received propranolol or placebo (control) during acute hospitalization. VO2 max was measured during a modified Bruce treadmill test at discharge and compared to values obtained using the Cooper, Bruce, American College of Sports Medicine, and Porro formulas. Pearson correlations and Bland–Altman analyses were used to compare measured and estimated values. Results: Ninety-nine children (propranolol n = 46,control n = 53) admitted at our facility between 2003 and 2016 were analyzed. Age at burn (propranolol 12 ± 4 years, control 12 ± 3 years,p = 0.893) and total body surface area burned (propranolol 44 ± 15%,control 49 ± 14%,p = 0.090) were comparable between groups. Measured VO2 max was higher in the propranolol group (25.5 ± 6.0 mL/min/kg vs. 22.0 ± 4.7 mL/min/kg,p = 0.002) and was generally lower than estimated values. Age, sex, inhalation injury, body mass index, exercise time, and maximal speed were predictive of measured VO2 max in the control group. Age, sex, and maximal speed were predictive in the propranolol group. Backward selection yielded the formula [7.63 + 2.16 × sex(females = 0,males = 1) + 0.41 × age(years) + 0.15 × maximal speed(m/min)] (R2 = 0.6525). Conclusions: Propranolol seems to have beneficial effects on cardiorespiratory capacity in burned children. However, estimated VO2 max with common formulas were too high. The VO2 max formula reported here is suitable for propranolol-treated children and the Porro formula for non-propranolol-treated children.
AB - Purpose: In burned children, exercise training increases maximal oxygen consumption (VO2 max) and can be combined with the nonspecific beta-blocker propranolol to decrease cardiac work. VO2 max is estimated if indirect calorimetry is not available. We compared measured and estimated VO2 max in severely burned children treated with or without propranolol to determine the suitability of commonly used formulas in these populations. Methods: Patients received propranolol or placebo (control) during acute hospitalization. VO2 max was measured during a modified Bruce treadmill test at discharge and compared to values obtained using the Cooper, Bruce, American College of Sports Medicine, and Porro formulas. Pearson correlations and Bland–Altman analyses were used to compare measured and estimated values. Results: Ninety-nine children (propranolol n = 46,control n = 53) admitted at our facility between 2003 and 2016 were analyzed. Age at burn (propranolol 12 ± 4 years, control 12 ± 3 years,p = 0.893) and total body surface area burned (propranolol 44 ± 15%,control 49 ± 14%,p = 0.090) were comparable between groups. Measured VO2 max was higher in the propranolol group (25.5 ± 6.0 mL/min/kg vs. 22.0 ± 4.7 mL/min/kg,p = 0.002) and was generally lower than estimated values. Age, sex, inhalation injury, body mass index, exercise time, and maximal speed were predictive of measured VO2 max in the control group. Age, sex, and maximal speed were predictive in the propranolol group. Backward selection yielded the formula [7.63 + 2.16 × sex(females = 0,males = 1) + 0.41 × age(years) + 0.15 × maximal speed(m/min)] (R2 = 0.6525). Conclusions: Propranolol seems to have beneficial effects on cardiorespiratory capacity in burned children. However, estimated VO2 max with common formulas were too high. The VO2 max formula reported here is suitable for propranolol-treated children and the Porro formula for non-propranolol-treated children.
KW - Burn injury
KW - Exercise
KW - Oxygen uptake
KW - Pediatric
KW - Physical activity
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U2 - 10.1016/j.burns.2018.06.004
DO - 10.1016/j.burns.2018.06.004
M3 - Article
C2 - 30005988
AN - SCOPUS:85049592067
SN - 0305-4179
VL - 44
SP - 2026
EP - 2033
JO - Burns
JF - Burns
IS - 8
ER -