Cardiopulmonary exercise testing in children with cystic fibrosis: one centre's experience

Weir, Elise; Burns, Paul; Devenny, Anne; Young, David; Paton, James Y.

doi:10.1136/archdischild-2016-310651

Cited by 20 publications

(22 citation statements)

References 34 publications

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“…Relative and similarly preserved peak _ VO 2 was found in our study groups. While most of the studies reported reduced exercise capacity in CF patients, some found normal values, mainly in pediatric patients with relatively preserved pulmonary function [9,10,28,29]. In our group of mild-moderate CF patients, peak _ VO 2 was preserved potentially due to the relatively young cohort and disease severity.…”

Section: Discussionmentioning

confidence: 49%

Exercise capacity in patients with cystic fibrosis vs non-cystic fibrosis bronchiectasis

Bar‐Yoseph¹,

Ilivitzki²,

Gur³

et al. 2018

Clinical Respiratory Physiology, Exercise and Functional Imaging

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Background Bronchiectasis is associated with morbidity, low exercise capacity and poor quality of life. There is a paucity of data on exercise capacity using cardiopulmonary exercise test (CPET) in non-cystic fibrosis (CF) bronchiectasis. Our aim was to compare exercise capacity using CPET in CF and non-CF bronchiectasis patients. Methods Cross-sectional retrospective/prospective controlled study assessing CPET using cycle ergometer. Exercise parameters and computed tomography (CT) findings were compared. Results: Hundred two patients with bronchiectasis and 88 controls were evaluated; 49 CF (age 19.7 ± 9.7 y/o, FEV 1 %predicted 70.9 ± 20.5%) and 53 non-CF (18.6 ± 10.6 y/o, FEV 1 % predicted 68.7 ± 21.5%). Peak oxygen uptake (peak _ VO 2) was similar and relatively preserved in both groups (CF 1915.5±702.0; non-CF 1740±568; control 2111.0±748.3 mL/min). Breathing limitation was found in the two groups vs. control; low breathing reserve (49% in CF; 43% non-CF; 5% control) and increased _ VE= _ VCO 2 (CF 31.4±4.1, non-CF 31.7±4.1 and control 27.2 ± 2.8). Oxygen pulse was lower in the non-CF; whereas a linear relationship between peak _ VO 2 vs. FEV 1 and vs. FVC was found only for CF. CT score correlated with _ VE= _ VCO 2 and negatively correlated with _ VO 2 =kg and post exercise oxygen saturation (SpO 2). Conclusions CPET parameters may differ between CF and non-CF bronchiectasis. However, normal exercise capacity may be found unrelated to the etiology of the bronchiectasis. Anatomical

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Section: Discussionmentioning

confidence: 49%

Exercise capacity in patients with cystic fibrosis vs non-cystic fibrosis bronchiectasis

Bar‐Yoseph¹,

Ilivitzki²,

Gur³

et al. 2018

Clinical Respiratory Physiology, Exercise and Functional Imaging

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“…In addition, supramaximal verification, as advocated by Williams et al, seems not to be clinically feasible, at least in our center experience, and a comprehensive response to its use, as well as for the use of secondary criteria to validate a maximal effort, has already been stated by the European Cystic Fibrosis Exercise Working Group . (2) Although maximum ventilation at peak (47.1 L/min) seems to be slightly below values of previous MST studies (ie, 64.0 ± 17.7, 57.7 ± 20.0, 64.0 ± 24.0), as above mentioned, the majority of patients achieved predicted VO 2 peak. (3) External validation should be conducted in future studies, as it requires a different sample.…”

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confidence: 79%

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Donadio

Vendrusculo

2019

Pediatric Pulmonology

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“…Guidelines recommend exercise testing and prescription from 10 years of age [3], although factors such as physical stature, and cognitive ability to understand the demands of the test, will influence whether a child can, and should, perform CPET [13]. A previous observational study of CPET in clinical practice has shown that young children (7 years) were unable to perform the test due to poor cooperation [4], and therefore testing of children should be considered on a case-by-case basis, as shown by the present review.…”

Section: Discussionmentioning

confidence: 99%

“…Given the importance of identifying and monitoring aerobic fitness, exercise testing is recommended to take place annually [2]. Cardiopulmonary exercise testing (CPET) is acknowledged as the 'gold standard' methodology in CF [3], with this service having been successfully implemented in some CF centres in the United Kingdom (UK) [4].…”

Section: Introductionmentioning

confidence: 99%

Challenges in Implementing Routine Cardiopulmonary Exercise Testing in Cystic Fibrosis Clinical Practice: a Single-Centre Review

Tomlinson

Trott

Williams

et al. 2020

SN Compr. Clin. Med.

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Cardiopulmonary exercise testing (CPET) is viewed by many as the gold standard for assessing exercise capacity in CF, being recommended on an annual basis. However, not all patients undergo CPET for varying reasons. This service evaluation retrospectively reviewed data from 179 (92 male) patients in a single CF centre in the UK to identify such reasons. A total of 75/179 patients underwent CPET, whilst 104/179 did not. Of these 104, 41 patients were ≤ 11 years of age. Of the remaining 63 patients, 26 did not undergo CPET for clinical reasons including needing IV antibiotics, musculoskeletal issues and obesity. Seventeen refused to undergo CPET because of reasons such as an unwillingness to travel and dislike of CPET. Twenty did not undergo CPET for miscellaneous reasons including difficulty contacting patients. Individuals with FEV 1 < 40% predicted were 85.7% less likely to undertake a CPET than individuals with FEV 1 ≥ 70% predicted. Understanding these challenges will assist clinical teams with future implementation of CPET into routine care, by identifying areas for improvement and establishing strategies for enhancing future provision of the test.

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Cardiopulmonary exercise testing in children with cystic fibrosis: one centre's experience

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Cited by 20 publications

References 34 publications

Exercise capacity in patients with cystic fibrosis vs non-cystic fibrosis bronchiectasis

Exercise capacity in patients with cystic fibrosis vs non-cystic fibrosis bronchiectasis

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Challenges in Implementing Routine Cardiopulmonary Exercise Testing in Cystic Fibrosis Clinical Practice: a Single-Centre Review

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