A two-test protocol (incremental/ramp (IWT) + supramaximal constant-load (CWR)) to affirm max and obviate reliance on secondary criteria has only been validated in highly fit children. In girls (n = 15) and boys (n = 12) with a wide range of VO 2 max (17-47 ml/kg/min), we hypothesized that this procedure would evince a VO 2 -WR plateau and unambiguous VO 2 max even in the presence of expiratory flow limitation (EFL). A plateau in the VO 2 -work rate relationship occurred in 75% of subjects irrespective of EFL There was a range in RER at max exercise for girls (0.97-1.14; mean 1.06 ± 0.04) and boys (0.98-1.09; mean 1.03 ± 0.03) such that 3/15 girls and 2/12 boys did not achieve the criterion RER. Moreover, in girls with RER > 1.0 it would have been possible to achieve this criterion at 78% VO 2 max. Boys achieved 92% VO 2 max at RER = 1.0. This was true also for HRmax where 8/15 girls' and 6/12 boys' VO 2 max would have been rejected based on HRmax being < 90% of age-predicted HRmax. In those who achieved the HRmax criterion, it represented a VO 2 of 86% (girls) and 87% (boys) VO 2 max. We conclude that this two-test protocol confirms VO 2 max in children across a threefold range of VO 2 max irrespective of EFL and circumvents reliance on secondary criteria.El protocolo que comprende dos test (incremental en rampa (TTI) + carga constante supramaximal) (CCS) aplicado para confirmar el consumo máximo de oxigeno y obviar la dependencia de los criterios secundarios ha sido solamente validado en niñas (n=15) y niños (n=12) bien entrenados, que poseían amplios rangos de VO 2 max (17-47 ml/kg/min). Nosotros hipnotizamos que este procedimiento podría evidenciar una meseta en la relación VO 2 -tasa de trabajo y por lo tanto indicar valores ambiguos de VO 2 max incluso en niños que presentan limitaciones del flujo espiratorio (LFE). La meseta en la relación entre el VO 2 -tasa de trabajo ocurre en el 75% de los sujetos, independientemente de que presenten LFE. El rango de valores en la relación de intercambio respiratorio (RER) se extendió entre 0.97 a 1.14 en niñas (M=1.06±0.04) y entre 0.98 a 1.09 en niños (M=1.03±0.03). De esta forma, 3/15 niñas y 2/12 niños no alcanzaron el criterio de RER para estimar el VO 2 max. Por otra parte, en las niñas que mostraron un RER>1.0 hubiera sido posible alcanzar este criterio con un valor del 78% VO 2 max. Los niños alcanzaron el 92% del VO 2 max con un RER=1.0. Esta respuesta, fue observada también
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