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Rixen M, Weickmann J, Gebauer RA, Weidenbach M, Markel F, Michaelis A, Dähnert I, Wüstenfeld J, Münch D, Poschart M, Sieber A, Schagatay E, Paech C. First Real-Life Data on the Diving Response in Healthy Children. Pediatr Cardiol 2024; 45:314-322. [PMID: 38177487 DOI: 10.1007/s00246-023-03370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024]
Abstract
Swimming and diving are popular recreational activities, representing an effective option in maintaining and improving cardiovascular fitness in healthy people. To date, only little is known about the cardiovascular adaption to submersion in children. This study was conducted to improve an understanding thereof. We used a stepwise apnea protocol with apnea at rest, apnea with facial immersion, and at last apnea during whole body submersion. Continuous measurement of heart rate, oxygen saturation, and peripheral resistance index was done. Physiologic data and analysis of influencing factors on heart rate, oxygen saturation, and peripheral vascular tone response are reported. The current study presents the first data of physiologic diving response in children. Data showed that facial or whole body submersion leads to a major drop in heart rate, and increase of peripheral resistance, while the oxygen saturation seems to be unaffected by static apnea in most children, with apnea times of up to 75 s without change in oxygen saturation.
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Affiliation(s)
- Mareike Rixen
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Johannes Weickmann
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Roman Antonin Gebauer
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Michael Weidenbach
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Franziska Markel
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Anna Michaelis
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Ingo Dähnert
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Jan Wüstenfeld
- Department of Sports Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Institut for Applied Training Science, Marschnerstrasse 29, Leipzig, Germany
| | - David Münch
- Landestauchsportverband Sachsen E.V, Am Sportforum 3, 04105, Leipzig, Germany
| | - Max Poschart
- SC DHfK Leipzig E.V, Am Sportforum 10, 04105, Leipzig, Germany
| | - Arne Sieber
- Oxygen Scientific GmbH, Eichbachgasse 151, 8041, Graz, Austria
| | - Erika Schagatay
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Christian Paech
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany.
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Into the Blue: First in Man Data on Diving Physiology in Fontan Patients. Pediatr Cardiol 2023; 44:179-186. [PMID: 35852567 DOI: 10.1007/s00246-022-02966-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/01/2022] [Indexed: 01/24/2023]
Abstract
Swimming and diving are popular recreational activities. As congenital heart disease, especially patients with univentricular hearts after Fontan palliation are thought to have reduced physiologic capacities for compensation of submersion-associated physiologic demands, current guidelines put restraints on this group of patients. Although these restrictions on doctoral advice place a significant burden on affected patients, it is especially interesting that these guideline recommendations are merely based on physiologic assumptions, i.e., expert consensus. A recent study by Paech et al. presented the first in vivo data on the effects of immersion in Fontan patients, stating no major adverse events in their study group as well as comparable physiologic adaption as reported in the literature for healthy people. Yet, submersion was not reflected in this study, and the current study therefore aimed to conduct a first study for the evaluation of the effects of submersion and apnea diving in Fontan patients. A control group of healthy adults as well as patients recruited from the Heart Center Leipzig, Department of pediatric cardiology underwent a standardized diving protocol including a static as well as dynamic apnea phase. Physiologic data were recorded. This study presents the first structured data on diving physiology in Fontan patients compared to healthy probands. There were no adverse events. The physiologic response to diving seems to be comparable between healthy probands and Fontan patients. Although, healthy probands did reach a much better performance, the basic mechanisms of physiologic adaption seem comparable.
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