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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 41-47, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
SR Wynn, DJ Driscoll, NK Ostrom, BA Staats, EJ O'Connell, CD Mottram and RL Telander
We studied 12 children with pectus excavatum (mean age, 13.8 years) using
pulmonary function and exercise testing. Eight patients had surgical repair
and were studied before and after repair. Four patients did not have repair
and were tested twice. The degree of chest wall deformity in the two groups
was similar. All patients reached 86% or more of their maximal predicted
heart rate with exercise. Total lung capacity decreased 8% (p less than
0.01) after operation. In the nonoperated control group, total lung
capacity was similar during both studies. The ratio of ventilation at
maximal exercise to maximal voluntary ventilation was 68% +/- 12% before
and 66% +/- 9% after operation in the operated group and 69% +/- 18% and
79% +/- 30% at two studies in the nonoperated group (nonsignificant
changes). Maximal oxygen uptake was 36.1 +/- 4.4 ml/kg/min preoperatively
and 38.1 +/- 8.1 postoperatively and 41.2 +/- 7.3 ml/kg/min and 43.0 +/-
6.9 on two studies in the nonoperated group (nonsignificant changes).
Cardiac output and stroke volume increased appropriately with exercise both
before and after operation. Operation had no physiologically significant
effect on the cardiorespiratory response to exercise. Slight changes in
cardiorespiratory function occurred in both operated and nonoperated
subjects. These results emphasize the importance of studying patients
before and after operation and of using a control group.
ARTICLES
Exercise cardiorespiratory function in adolescents with pectus excavatum. Observations before and after operation
Department of Pediatrics, Mayo Clinic, Rochester, MN 55905.
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