Page 133 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation
Preparation
Following selection, the transplant participants began an individual training schedule based
on the results of the CPET and peripheral muscle strength testing. Training zones were
determined, and a schedule was composed with a minimum of three training sessions per
week. Depending on the test results, the focus was adjusted towards cardio or strength
training and initiated six months prior to departure. Additionally, three central training
sessions were organized whereby transplant participants and members of the medical team
walked distances up to 20 kilometers which also allowed for all to become acquainted with
each other.
All participants were vaccinated according to the current recommendations and
received malaria prophylaxis. Beginning one day prior to the climb up until reaching the
summit, all participants received a prophylactic dose of acetazolamide (125 mg twice daily)
to prevent acute mountain sickness. One Tx-participant and one control used a
homeopathic agent instead of acetazolamide. Furthermore, a

uid intake of four to

ve
liters per day was recommended to all participants. All transplant participants continued
their own immunosuppressant medication regimen.
Daily measurements
All measurements were performed twice daily (AM and PM) and consisted of the
measurement of blood pressure (manually); oxygen saturation; heart frequency (Pulse
oximetry, Contec CM550D, Contec Medical System Co, LTD, China); and symptoms of
altitude sickness. Symptoms of altitude sickness were monitored using the Lake Louise
Acute Mountain Sickness Scores.
and/or lightheadedness’; and ‘di

perceived exertion (6–20; 20 = maximal exertion) were registered.
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Hereby, scores on a four point scale (0–3) were
assigned to: ‘headache’; ‘gastrointestinal complaints’; ‘fatigue and/or weakness’; ‘dizziness
culty sleeping’. Additionally, Borg scores for the rate of
Daily measurements
were not performed on the morning of the summit attempt because of lack of time due to
departure at midnight. No measurements were performed at the summit because staying at
the summit longer than needed is discouraged because of an increasing risk of acute
mountain sickness.
Capillary blood analysis
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Capillary blood was analyzed on day 0 (1000m), day 5 (4030m), day 9 (1400m), and six
weeks following the expedition (sea level) with a handheld analysis system (i-Stat1 system,
Abbott Point of Care Inc., Princeton, NJ, USA). Calibration to the barometric pressure was
performed at each altitude before measurements. Analyses were performed utilizing CG4+
cartridges, which use a blood sample of 95
micro
L. Data was generated on pH (hydrogen
ion concentration), pCO2 (carbon dioxide pressure, kPa), pO2 (oxygen pressure, kPa),
bicarbonate (HCO3-, mmol/L), Base Excess (metabolic component compensating pH
deviations, mmol/L), saO2 (oxygen saturation, %), and lactate (mmol/L).
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