PHYSICAL-FITNESS TESTING IN CHILDREN OPERATED ON FOR TRACHEOESOPHAGEAL FISTULA

The maximal physical activity capacity of children operated on for tra cheoesophageal fistula (TEF) has not been clearly defined. Eight patie nts (average age, 12 years) successfully operated on for TEF at birth underwent maximal exercise stress testing on a treadmill, according to the Bruce protocol, to test physical work capacity. Heart rate (HR), oxygen consumption (VO2), and pulmonary ventilation (VE) were measured by a portable lightweight telemetric device. Nine healthy children se rved as controls. Exercise duration was significantly lower for TEF su bjects than for controls (11.6 +/- 1.7 minutes v 15.1 +/- 2.3 minutes; P <.01). Mean HR at rest and during exercise did not differ between t he groups. All children reached the maximum HR according to their age; however, for the majority of TEF patients, this occurred at an earlie r stage than in the controls. No differences were seen in mean VO2 at rest and on exertion between TEF and control children. However, maxima l VO2, as measured at the end of exercise, was significantly different when normalized per kilogram of body weight (VO2/kg = 52.3 +/- 5.8 v 33.3 +/- 6.6; P <.005). The physical rehabilitation of TEF children us ually takes into account only respiratory and nutritional factors. How ever, complete assessment of their cardiac and respiratory function, a t rest and on exertion, also should be performed, because this may sho w that some patients have reduced motor performance; evidence is now a ccumulating that these children can safely participate in the same phy sical activities of their healthy peers. Copyright (C) 1995 by W.B. Sa unders Company