Reha Kongresse 2018
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P42

Effect of oxygen therapy on exercise performance in patients with cyanotic congenital heart disease

S. Saxer1, L. R. Calendo1, M. Lichtblau1, J. Müller1, A. Carta1, F. Gautschi1, M. Greutmann1, S. Ulrich1 (1Zürich)


Einleitung

Patients with unrepaired cyanotic congenital heart disease (CHD) suffer from aggravated hypoxemia during exercise. We investigated the effect of supplemental oxygen on exercise performance in patients with cyanotic CHD.

Methodik

In this randomized, sham-controlled, single-blind, cross-over trial cyanotic CHD-patients underwent four cycle exercise tests to exhaustion, while breathing either oxygen-enriched (FiO2 0.50, oxygen) or ambient air (FiO2 0.21, air) using incremental (IET) or constant work-rate (CWRET) protocols (75% maximal work rate achieved under FiO2 0.21). Pulmonary gas-exchange, electrocardiogram, arterial blood gases, cerebral and quadriceps muscle tissue oxygenation (CTO and QMTO) by near-infrared spectroscopy were measured.

Resultate

We included seven patients with cyanotic CHD (4 Eisenmenger syndrome, 3 unrepaired cyanotic defects, 4 women) median(quartiles) age 36 (32;50) years, BMI 23 (20;26) kg/m2and SpO2 at rest 87 (83;89) %. When comparing supplemental oxygen with ambient air during exercise, maximal work-rate in IET increased from 77 (61;114) W to 83 (67;136) W, median difference 9 (0;22) W (p=0.046) and CWRET-time increased from 412s (325;490) to 468s (415;553), median increase 56 (39;126) s (p=0.018). In both IET and CWRET blood oxygenation was significantly higher and ventilatory equivalent for carbon dioxide significantly lower at end-exercise with oxygen compared to air, whereas CTO and QMTO did not significantly differ.

Schlussfolgerungen

Patients with cyanotic CHD significantly improved their exercise performance, in terms of maximal work-rate and endurance time along with an improved blood oxygenation and ventilatory efficacy with supplemental oxygen compared to air.

Bedeutung

Patients with cyanotic CHD may benefit from oxygen therapy during daily physical activities and training.