23 research outputs found
Measuring the Effects of Massage on Exercise Performance and Cardiopulmonary Response in Children With and Without Heart Disease: A Pilot Study
Background: Congenital heart disease, a common and serious birth defect, affects 8 per 1000 live born infants. Decreased exercise capacity and development of obesity is common in this population. These children may benefit from therapies, such as massage therapy, that could enhance cardiovascular and skeletal muscle function when they exercise.
Purpose: A pilot study conducted at the pediatric cardiology clinic of the Mattel Childrenâs Hospital of the University of CaliforniaâLos Angeles examined the safety and feasibility of measuring the effects of pre-exercise massage on exercise performance and cardiopulmonary response in children with and without heart disease.
Participants and Methods: Sixteen children (mean age: 9.2 ± 2.2 years) participated in the study. Ten participants had various forms of heart disease, and six children were healthy. A female certified massage therapist with specialized training in pediatric massage provided a 30-minute massage to the participants. Using a standard protocol, each participant underwent two exercise tests: one test with and one without pre-exercise massage. Heart rate, blood pressure, and oxygen uptake (VO2) were measured in the participants.
Results: All recruited participants completed the study. No adverse events occurred during any of the exercise tests or massage sessions. Measurements during exercise with or without a preceding massage were compared, and the pre-exercise massage condition yielded a significantly higher heart rate and higher minute ventilation. Measurements during exercise in children with heart disease and in healthy participants showed no significant differences in peak heart rate, blood pressure, peak VO2, peak work rate, minute ventilation, or respiratory quotient.
Conclusions: In this study, peak heart rate, peak VO2, and peak minute ventilation were higher when children received a massage before exercise testing. Larger studies will be needed to investigate the strength of this finding. Future studies should include measurements of anxiety and psychological factors in addition to cardiopulmonary measures
Impact of Palivizumab on RSV Hospitalizations for Children with Hemodynamically Significant Congenital Heart Disease
The objective of this study was to evaluate the impact of palivizumab prophylaxis on respiratory syncytial virus (RSV) hospitalizations among children with hemodynamically significant congenital heart disease (CHD). In 2003, the American Academy of Pediatrics (AAP) revised the bronchiolitis policy statement and recommended the use of palivizumab in children <24 months old with hemodynamically significant CHD (HS-CHD). California statewide hospital discharge data from years 2000â2002 (pre-AAP policy revision) were compared to those from years 2004â2006 (post-AAP policy revision). Hospitalizations due to RSV bronchiolitis for children <2 years of age were identified by IDC-9 CM codes 4661.1, 480.1, and 079.6 as the Principal Diagnosis. Children with CHD and children with HS-CHD were identified by the codiagnoses. The overall RSV hospitalization rate was 71 per 10,000 children <2 years of age. Of all RSV hospitalizations, 3.0% were among children with CHD, and 0.50% among children with HS-CHD. HS-CHD patients accounted for 0.56% of RSV hospitalizations in 2000â2002, compared to 0.46% RSV hospitalizations in 2004â2006. That represents a 19% reduction in RSV hospitalizations among HS-CHD patients after 2003. The 19% decrease in RSV hospitalizations equates to seven fewer hospitalizations (76 hospital days) per year among HS-CHD patients. We conclude that, since the recommendation of palivizumab for children with HS-CHD in 2003, the impact on RSV hospitalizations in California among HS-CHD patients has been limited. Considering the high cost of palivizumab administration, the cost-benefit of RSV prophylaxis with palivizumab warrants further investigation
Comparison of upright and semi-recumbent postures for exercise echocardiography in healthy children.
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Comparison of upright and semi-recumbent postures for exercise echocardiography in healthy children.
This study was conducted in 20 healthy children to compare a semi-recumbent posture using back support with an upright posture for exercise echocardiography. It was found that a semi-recumbent position with back support is superior to an upright position, with no difference in physiologic measurements
Comparison of Formulas for Calculation of the Corrected QT Interval in Infants and Young Children
ObjectiveTo compare 4 heart rate correction formulas for calculation of the rate corrected QT (QTc) interval among infants and young children.Study designR-R and QT intervals were measured from digital electrocardiograms. QTc were calculated with the Bazett, Fridericia, Hodges, and Framingham formulas. QTc vs R-R graphs were plotted, and slopes of the regression lines compared. Slopes of QTc-R-R regression lines close to zero indicate consistent QT corrections over the range of heart rates.ResultsWe reviewed electrocardiograms from 702 children, with 233 (33%) <1 year of age and 567 (81%) <2 years. The average heart rate was 122 ± 20 bpm (median 121 bpm). The slopes of the QTc-R-R regression lines for the 4 correction formulas were -0.019 (Bazett); 0.1028 (Fridericia); -0.1241 (Hodges); and 0.2748 (Framingham). With the Bazett formula, a QTc >460 ms was 2 SDs above the mean, compared with "prolonged" QTc values of 414, 443, and 353 ms for the Fridericia, Hodges, and Framingham formulas, respectively.ConclusionsThe Bazett formula calculated the most consistent QTc; 460 ms is the best threshold for prolonged QTc. The study supports continued use of the Bazett formula for infants and children and differs from the use of the Fridericia correction during clinical trials of new medications
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Comparison of upright and semi-recumbent postures for exercise echocardiography in healthy children.
This study was conducted in 20 healthy children to compare a semi-recumbent posture using back support with an upright posture for exercise echocardiography. It was found that a semi-recumbent position with back support is superior to an upright position, with no difference in physiologic measurements
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Asthma Hospitalizations Among Homeless Children in New York State
Asthma is widely prevalent among US children, particularly in homeless children, who often lack proper medication storage or the ability to avoid environmental triggers. In this study, we assess asthma-attributed health care use among homeless youth. We hypothesize that asthma hospitalization rates, symptom severity, and admission through the emergency department (ED) will be higher among homeless youth compared with nonhomeless youth. This secondary data analysis identified homeless and nonhomeless pediatric patients (<18 years old) with a primary diagnosis of asthma from New York statewide inpatient databases between 2009 and 2014. Hospitalization rate, readmission rate, admission through the ED, ventilation use, ICU admittance, hospitalization cost, and length of stay were measured. We identified 71â837 asthma hospitalizations, yielding 73.8 and 2.3 hospitalizations per 1000 homeless and nonhomeless children, respectively. Hospitalization rates varied by nonhomeless income quartile, with low-income children experiencing higher rates (5.4) of hospitalization. Readmissions accounted for 16.0% of homeless and 12.5% of nonhomeless hospitalizations. Compared with nonhomeless patients, homeless patients were more likely to be admitted from the ED (odds ratio 1.96; 95% confidence interval: 1.82-2.12; P < .01), and among patients >5 years old, homeless patients were more likely to receive ventilation (odds ratio 1.45; 95% confidence interval: 1.01-2.09; P = .04). No significant differences were observed in ICU admittance, cost, or length of stay. Homeless youth experience an asthma hospitalization rate 31 times higher than nonhomeless youth, with higher rates of readmission. Homeless youth live under uniquely challenging circumstances. Tailored asthma control strategies and educational intervention could greatly reduce hospitalizations