Grant: Travel Awards - Institute Community Support

Children born with complex congenital heart disease (CHD) have abnormal cardiopulmonary physiology. Research has shown that these children are at risk of energy imbalances due to their abnormally high energy demands. Surgical repair is available for some patients, while others undergo palliative procedures. The purpose of this study was to determine whether the resting metabolic rate (RMR) of children with palliated CHD differs from those whose heart defect was repaired. Children aged 6 to 11 years with complex CHD were fitted with a facemask connected to a portable metabolic system. Expired oxygen and carbon dioxide were measured for 10 minutes after the participant had been lying still in a darkened room for at least 30 minutes. Measurements from 5 to 10 minutes were averaged and RMR was calculated. 30 participants (18 female), mean age 9.2 ± 1.9 years, included 10 children with a Fontan palliation and 20 children with repair of tetrology of fallot (n=10) or transposition of the great arteries (n= 10). Mean RMR for each group was 1120.9±364.8, 1192.2±306.9 and 1245.8±331.1 kcal/day respectively. RMR did not differ between groups (F(2,27)=.34, p=.72) or by age (F(6,17)=.54, p = .77) or sex (F(1,17) = 1.44, p = .25). In comparison to age or weight matched healthy children, the RMR of children with CHD also did not differ significantly from published data when participants were matched by age (mean difference = 55.8, 95% CI [-82.2, 193.8], p=.42) or weight (mean difference 15.1, 95% CI [-116.3, 146.4], p=.82). This study has shown that children with complex CHD have similar RMRs in comparison to age-matched healthy children, regardless of whether the heart defect was palliated or repaired. These results suggest that expectations for energy demands (e.g., growth, physical activity) should be similar for all children. Future research is required to evaluate whether the energy demands remain similar during the submaximal physical activities typical of childhood play.