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Moreau J, Socchi F, Renoux MC, Requirand A, Abassi H, Guillaumont S, Matecki S, Huguet H, Avesani M, Picot MC, Amedro P. Cardiopulmonary fitness in children with asthma versus healthy children. Arch Dis Child 2023; 108:204-210. [PMID: 36446481 DOI: 10.1136/archdischild-2021-323733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To evaluate, with a cardiopulmonary exercise test (CPET), the cardiopulmonary fitness of children with asthma, in comparison to healthy controls, and to identify the clinical and CPET parameters associated with the maximum oxygen uptake (VO2max) in childhood asthma. DESIGN This cross-sectional controlled study was carried out in CPET laboratories from two tertiary care paediatric centres. The predictors of VO2max were determined using a multivariable analysis. RESULTS A total of 446 children (144 in the asthma group and 302 healthy subjects) underwent a complete CPET. Mean VO2max was significantly lower in children with asthma than in controls (38.6±8.6 vs 43.5±7.5 mL/kg/min; absolute difference (abs. diff.) of -4.9 mL/kg/min; 95% CI of (-6.5 to -3.3) mL/kg/min; p<0.01) and represented 94%±9% and 107%±17% of predicted values, respectively (abs. diff. -13%; 95% CI (-17 to -9)%; p<0.01). The proportion of children with an impaired VO2max was four times higher in the asthma group (24% vs 6%, p<0.01). Impaired ventilatory efficiency with increased VE/VCO2 slope and low breathing reserve (BR) were more marked in the asthma group. The proportion of children with a decreased ventilatory anaerobic threshold (VAT), indicative of physical deconditioning, was three times higher in the asthma group (31% vs 11%, p<0.01). Impaired VO2max was associated with female gender, high body mass index (BMI), FEV1, low VAT and high BR. CONCLUSION Cardiopulmonary fitness in children with asthma was moderately but significantly altered compared with healthy children. A decreased VO2max was associated with female gender, high BMI and the pulmonary function. TRIAL REGISTRATION NUMBER NCT04650464.
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Affiliation(s)
- Johan Moreau
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Floriane Socchi
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiopulmonary Rehabilitation Centre, Saint-Pierre Institute, Palavas-les-Flots, France
| | - Marie Catherine Renoux
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France
| | - Anne Requirand
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France
| | - Hamouda Abassi
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Sophie Guillaumont
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiopulmonary Rehabilitation Centre, Saint-Pierre Institute, Palavas-les-Flots, France
| | - Stefan Matecki
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Helena Huguet
- Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France
| | - Martina Avesani
- Paediatric and Congenital Cardiology Department, M3C National CHD Reference Centre, Bordeaux University Hospital, Bordeaux, France
| | - Marie-Christine Picot
- Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France.,CIC 1411, INSERM, University of Montpellier, Montpellier, France
| | - Pascal Amedro
- Paediatric and Congenital Cardiology Department, M3C National CHD Reference Centre, Bordeaux University Hospital, Bordeaux, France .,IHU Liryc, INSERM 1045, University of Bordeaux, Bordeaux, France
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4
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Fauroux B, Khirani S, Amaddeo A, Massenavette B, Bierme P, Taytard J, Stremler N, Baravalle-Einaudi M, Mazenq J, Ioan I, Schweitzer C, Lampin ME, Binoche A, Mordacq C, Bergounioux J, Mbieleu B, Rubinsztajn R, Sigur E, Labouret G, Genevois A, Becourt A, Hullo E, Pin I, Debelleix S, Galodé F, Bui S, Moreau J, Renoux MC, Matecki S, Lavadera ML, Heyman R, Pomedio M, Le Clainche L, Bokov P, Masson A, Hangard P, Menetrey C, Jokic M, Gachelin E, Perisson C, Pervillé A, Fina A, Giovannini-Chami L, Fleurence E, Barzic A, Breining A, Ollivier M, Labbé G, Coutier L, Aubertin G. Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study. Respir Med 2021; 181:106388. [PMID: 33848922 DOI: 10.1016/j.rmed.2021.106388] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe the characteristics of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in France. DESIGN Cross-sectional national survey. SETTING Paediatric CPAP/NIV teams of 28 tertiary university hospitals in France. PATIENTS Children aged <20 years treated with CPAP/NIV since at least 3 months on June 1st, 2019. INTERVENTION An anonymous questionnaire was filled in for every patient. RESULTS The data of 1447 patients (60% boys), mean age 9.8 ± 5.8 years were analysed. The most frequent underlying disorders were: upper airway obstruction (46%), neuromuscular disease (28%), disorder of the central nervous system (13%), cardiorespiratory disorder (7%), and congenital bone disease (4%). Forty-five percent of the patients were treated with CPAP and 55% with NIV. Treatment was initiated electively for 92% of children, while 8% started during an acute illness. A poly(somno)graphy (P(S)G) was performed prior to treatment initiation in 26%, 36% had a P(S)G with transcutaneous carbon dioxide monitoring (PtcCO2), while 23% had only a pulse oximetry (SpO2) with PtcCO2 recording. The decision of CPAP/NIV initiation during an elective setting was based on the apnea-hypopnea index (AHI) in 41% of patients, SpO2 and PtcCO2 in 25% of patients, and AHI with PtcCO2 in 25% of patients. Objective adherence was excellent with a mean use of 7.6 ± 3.2 h/night. Duration of CPAP/NIV was 2.7 ± 2.9 years at the time of the survey. CONCLUSION This survey shows the large number of children treated with long term CPAP/NIV in France with numerous children having disorders other than neuromuscular diseases.
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Affiliation(s)
- Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France; Université de Paris, VIFASOM, F-75004, Paris, France.
| | - Sonia Khirani
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France; Université de Paris, VIFASOM, F-75004, Paris, France; ASV Santé, F-92000, Gennevilliers, France
| | - Alessandro Amaddeo
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France; Université de Paris, VIFASOM, F-75004, Paris, France
| | - Bruno Massenavette
- Paediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, 69677, Bron, France
| | - Priscille Bierme
- Pediatric Pulmonology and Allergology Unit, Hospices Civils de Lyon, 69677, Bron, France
| | - Jessica Taytard
- Pediatric Pulmonology Department, AP-HP, Hôpital Armand Trousseau, F-75012, Paris, France; Sorbonne Université, INSERM UMR-S, 1158, Paris, France
| | - Nathalie Stremler
- Pediatric Ventilation Unit, Pediatric Department, AP-HM, Hôpital La Timone, 13385, Marseille, France
| | | | - Julie Mazenq
- Pediatric Ventilation Unit, Pediatric Department, AP-HM, Hôpital La Timone, 13385, Marseille, France
| | - Iulia Ioan
- Pediatric Department, University Children's Hospital, CHRU Nanc, Université de Lorraine, DevAH, F-54000, Nancy, France
| | - Cyril Schweitzer
- Pediatric Department, University Children's Hospital, CHRU Nanc, Université de Lorraine, DevAH, F-54000, Nancy, France
| | - Marie Emilie Lampin
- Pediatric Intensive Care Unit, Hôpital Jeanne de Flandre, CHU Lille, Avenue Eugène Avinée, 59037, Lille Cédex, France
| | - Alexandra Binoche
- Pediatric Intensive Care Unit, Hôpital Jeanne de Flandre, CHU Lille, Avenue Eugène Avinée, 59037, Lille Cédex, France
| | - Clemence Mordacq
- Pediatic Pulmonology and Allergology Unit, Hôpital Jeanne de Flandre, CHU Lille, Avenue Eugène Avinée, 59037, Lille Cédex, France
| | - Jean Bergounioux
- Pediatric Intensive Care Unit, AP-HP, Hôpital Raymond Poincaré, F-92380, Garches, France
| | - Blaise Mbieleu
- Pediatric Intensive Care Unit, AP-HP, Hôpital Raymond Poincaré, F-92380, Garches, France
| | | | - Elodie Sigur
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, 31000, Toulouse, France
| | - Geraldine Labouret
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, 31000, Toulouse, France
| | - Aline Genevois
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, 31000, Toulouse, France
| | - Arnaud Becourt
- Pediatric Pulmonology, CHU Amiens Picardie, 80054, France
| | - Eglantine Hullo
- Pediatric Pulmonology Unit, Hôpital Couple-Enfant, CHU Grenoble, 38000, Grenoble, France
| | - Isabelle Pin
- Pediatric Pulmonology Unit, Hôpital Couple-Enfant, CHU Grenoble, 38000, Grenoble, France; INSERM, Institute for Advanced Biosciences, 38000, Grenoble, France; Grenoble Alpes University, 38000, Grenoble, France
| | - Stéphane Debelleix
- Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, CIC-P Bordeaux 1401, CHU de Bordeaux, 33076, Bordeaux, France
| | - François Galodé
- Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, CIC-P Bordeaux 1401, CHU de Bordeaux, 33076, Bordeaux, France
| | - Stéphanie Bui
- Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, CIC-P Bordeaux 1401, CHU de Bordeaux, 33076, Bordeaux, France
| | - Johan Moreau
- Pediatric Cardiology and Pulmonology Department, Montpellier University Hospital, 34000, Montpellier, France; Physiology and Experimental Biology of Heart and Muscles Laboratory-PHYMEDEXP, UMR CNRS 9214, INSERM U1046, University of Montpellier, 34000, Montpellier, France
| | - Marie Catherine Renoux
- Pediatric Cardiology and Pulmonology Department, Montpellier University Hospital, 34000, Montpellier, France
| | - Stefan Matecki
- Pediatric Cardiology and Pulmonology Department, Montpellier University Hospital, 34000, Montpellier, France; Functional Exploration Laboratory, Physiology Department, University Hospital, 34000, Montpellier, France
| | - Marc Lubrano Lavadera
- Respiratory Diseases, Allergy and CF Unit, Pediatric Department, University Hospital Charles Nicolle, 76000, Rouen, France
| | - Rachel Heyman
- Pediatric Unit, Department of Physical Medicine and Rehabilitation, Hôpital Pontchaillou, Rennes, 35033, Rennes, France
| | - Michael Pomedio
- Pediatric Intensive Care Unit, American Memorial Hospital, CHU Reims, 51000, Reims, France
| | - Laurence Le Clainche
- Pediatric Noninvasive Ventilation, AP-HP, Hôpital Robert Debré, F-75018, Paris, France
| | - Plamen Bokov
- Pediatric Noninvasive Ventilation, AP-HP, Hôpital Robert Debré, F-75018, Paris, France
| | - Alexandra Masson
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, 87042, Limoges, France
| | - Pauline Hangard
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, 87042, Limoges, France
| | - Celine Menetrey
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, 87042, Limoges, France
| | - Mikael Jokic
- Pediatric Intensive Care Unit, CHU de Caen Normandie, 14033, Caen, France
| | - Elsa Gachelin
- Pediatric Department, CHU Félix Guyon, F-97404, Saint Denis, La Réunion, France
| | - Caroline Perisson
- Pediatric Department, CHU Sud Réunion, F-97448, Saint Pierre, La Réunion, France
| | - Anne Pervillé
- Hôpital d'Enfants - ASFA, F-97404, Saint Denis, La Réunion, France
| | - Agnes Fina
- Pediatric Pulmonology and Allergology Department, Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France
| | - Lisa Giovannini-Chami
- Pediatric Pulmonology and Allergology Department, Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France
| | | | - Audrey Barzic
- Pediatric Department, CHU Brest, 29200, Brest, France
| | - Audrey Breining
- Pediatric Department, CHU Strasbourg, 67000, Strasbourg, France
| | - Morgane Ollivier
- Pediatric Intensive Care Unit, CHU Angers, 49100, Angers, France
| | - Guillaume Labbé
- Pediatric Pulmonology and Allergology Unit, CHU d'Estaing, 63003, Clermont-Ferrand, France
| | - Laurianne Coutier
- Paediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, 69677, Bron, France
| | - Guillaume Aubertin
- Pediatric Pulmonology and Allergology Unit, Hospices Civils de Lyon, 69677, Bron, France; Sorbonne Université, INSERM UMR-S 938, Centre de Recherche Saint-Antoine (CRSA), F-75014, Paris, France; Centre de Pneumologie de l'enfant, Ramsay Générale de Santé, 92100, Boulogne-Billancourt, France
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