Institutional members access full text with Ovid®

Share this article on:

Children with Burn Injury Have Impaired Cardiac Output during Submaximal Exercise


Medicine & Science in Sports & Exercise: October 2017 - Volume 49 - Issue 10 - p 1993–2000
doi: 10.1249/MSS.0000000000001329
Clinical Sciences

Introduction Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output () and stroke volume (SV) during submaximal exercise.

Methods Five children with 49% ± 4% total body surface area (BSA) burned (two female, 11.7 ± 1 yr, 40.4 ± 18 kg, 141.1 ± 9 cm) and eight similar nonburned controls (five female, 12.5 ± 2 yr, 58.0 ± 17 kg, 147.3 ± 12 cm) with comparable exercise capacity (peak oxygen consumption [peak V˙O2]: 31.9 ± 11 vs 36.8 ± 8 mL O2·kg−1·min−1, P = 0.39) participated. The exercise protocol entailed a preexercise (pre-EX) rest period followed by 3-min exercise stages at 20 W and 50 W. V˙O2, HR, (via nonrebreathing), SV (/HR), and arteriovenous O2 difference ([a-v]O2diff, / V˙O2) were the primary outcome variables.

Results Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that was approximately 27% lower in the burned than the nonburned group at 20 W of exercise (burned 5.7 ± 1.0 vs nonburned: 7.9 ± 1.8 L·min−1) and 50 W of exercise (burned 6.9 ± 1.6 vs nonburned 9.2 ± 3.2 L·min−1) (G–EX interaction, P = 0.012). SV did not change from rest to exercise in burned children but increased by approximately 24% in the nonburned group (main effect for EX, P = 0.046). Neither [a-v] O2diff nor V˙O2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G–EX interaction, P = 0.004). When normalized to BSA, SV (index) was similar between groups; however, (index) remained attenuated in the burned group (G–EX interaction, P < 0.008).

Conclusions Burned children have an attenuated cardiovascular response to submaximal exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.

1Shriners Hospitals for Children, Galveston, TX, 2Department of Surgery, University of Texas Medical Branch, Galveston, TX; 3Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX; and 4KCBeck Physiological Consulting, LLC, Liberty, UT

Address for correspondence: Eric Rivas, Ph.D., Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main Street, Lubbock, TX 79409; E-mail:

Submitted for publication January 2017.

Accepted for publication May 2017.

© 2017 American College of Sports Medicine