McBride Michael G, Binder Tracy Jo, Paridon Stephen M
Divisions of Cardiology, The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
J Cardiopulm Rehabil Prev. 2007 Jul-Aug;27(4):219-22. doi: 10.1097/01.HCR.0000281766.59781.e8.
To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support.
Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support.
Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning.
Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred.
Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.
确定针对一组接受多种正性肌力药物支持的小儿心脏移植候选者的住院运动训练计划的安全性和可行性。
终末期心脏病患儿通常需要心脏移植。目前，尚无关于住院运动训练计划在接受正性肌力药物支持的等待心脏移植的小儿患者中的安全性和可行性的数据。
20名门诊患者（11名男性；年龄13.6±3.2岁）在等待心脏移植期间入院、登记并随后纳入运动训练计划。患者诊断包括扩张型心肌病（n = 15）、限制型心肌病（n = 1）和单心室功能衰竭（n = 4）。正性肌力药物支持包括多巴酚丁胺、多巴胺或米力农的联合使用。运动课程安排为每周三次，持续30至60分钟，包括有氧运动和肌肉骨骼调节。
在6.2±4.2个月的时间里，在可能的1508次运动训练课程中进行了1251次，共有615小时（每次课程26.3±2.7分钟）用于低强度有氧运动。不依从的原因包括医疗状况、人员配备或患者合作的变化。发生了两起不良事件（癫痫发作），但均未导致退出该计划。未发生低血压或严重复杂性心律失常的不良事件。未发生药物给药并发症或静脉通路丧失。
本研究数据表明，因全心或双心室心力衰竭而接受正性肌力药物支持的小儿患者能够安全地参与依从性相对中等至高的运动训练计划。
