Open Field Exercise Testing in Pediatric Congenital Heart Disease Patients: A Subsumption of Cardiovascular Parameters.

Heart failure is a common phenomenon in congenital heart disease patients. Cardiopulmonary exercise testing is used for a reliable assessment of heart failure but is still challenging, especially for young children. Implementing mobile cardiopulmonary exercise testing (CPET) can close that diagnostic gap. While average values for healthy children have already been published, this study aims to describe typical ranges of cardiovascular performance parameters of young children with congenital heart disease performing an 8-min running cardiopulmonary exercise test. Children aged 4-8 years with common congenital heart defects after corrective surgery (Tetralogy of Fallot; transposition of the great arteries and univentricular hearts after palliation) were included. The outdoor running protocol consisted of slow walking, slow jogging, fast jogging, and maximum speed running. Each exercise was performed for 2 min, except the last, in which children were instructed to keep up maximal speed as long as possible. A total of 78 children (45 male/33 female, mean age 6,24) with congenital heart disease participated in the study, of which 97% completed the CPET successfully. A detailed description of participating patients, including data on cardiac function and subjective fitness levels, is given to help physicians use this method to classify their patients. This study presents a typical range for cardiovascular performance parameters in a population of 4-8-year-old children with congenital heart disease tested in a newly developed outdoor running protocol for CPET.

Potential of in-situ sensors with ion-selective electrodes for aeration control at wastewater treatment plants.

A pilot-scale activated sludge wastewater treatment plant (WWTP) operated with nitrification and pre-denitrification was monitored with a set of on-line sensors for over 3 years. Wet-chemistry ex-situ analyzers, UV and UV-Visible in-situ sensors and in-situ sensors based on ion-selective electrodes (ISE) were used. New ISE sensors for ammonium, nitrate and nitrite, adapted to water and wastewater matrices, have been released in recent years, With adequate quality control they proved to be highly accurate and reliable in WWTP influents and activated sludge (AS) reactors even at the end of the biological treatment zone, working at low ammonium concentrations (1-2 mgN/l). The ammonium measurement was used to test several feed-forward and feed-back aeration control strategies. The first aim was to keep inorganic nitrogen compounds, i.e. ammonium, nitrate and particularly nitrite, as low as possible in the effluent, and within Swiss national standards (<2.0 mgNH(4)-N/l, <0.3 mgNO(2)-N/l, 24 h average). All the strategies were successful at keeping ammonium low and subsequently at gaining denitrification capacity to significantly reduce the total nitrogen discharge. Some control strategies however generated temporary peaks of ammonium or even accumulation of nitrite.