Cardiopulmonary Exercise Testing in Pediatrics

Abstract

Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared with adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine. As the physiological responses to exercise change during growth and development, appropriate pediatric reference values are essential for an adequate interpretation of the cardiopulmonary exercise test.

Physical activity and aerobic fitness in children after liver transplantation

“…Although during CPET the response is measured objectively, the performance of the test is depending on the motivation to reach maximal effort. Young children can validly perform a CPET if the right equipment is available (pediatric cycle ergometer) and the child is able to understand the instructions …”

“…Young children can validly perform a CPET if the right equipment is available (pediatric cycle ergometer) and the child is able to understand the instructions. 27…”

A Systematic Approach to Interpreting the Cardiopulmonary Exercise Test in Pediatrics

“…Within pediatric medicine, clinical exercise physiology is a discipline in which the integrated response of various physiological systems (pulmonary, cardiovascular, hematologic, metabolic, and musculoskeletal) is objectively assessed and analyzed at rest, during progressive exercise, and during recuperation, often using cardiopulmonary exercise testing (39). Using this noninvasive and dynamic integrative approach, it is possible to uncover potential physiological causes of unexplained exercise-related complaints and symptoms and to observe specific pathophysiological patterns based on physiological responses or abnormalities (39). Furthermore, this integrated approach provides the clinician with a broad spectrum of information to support their physiological reasoning and clinical decision making.…”

Exercise testing in patients with cystic fibrosis—importance of ventilatory parameters

“…The high prognostic value of the V E /VCO 2 slope in other clinical populations may be partly explained by the fact that it is effort-independent, and thus less susceptible to false interpretation due to early test termination either by the patient or investigator. Indeed, achieving maximal effort during a CPET is dependent on a range of factors including the testing protocol used, intrinsic motivation of the participant, and the participant’s perceived exertion (Takken et al 2017). Routine exercise testing in CF is now recommended (Hebestreit et al 2015); therefore, monitoring changes in exercise ventilatory parameters may provide enhanced prognostic value in CF compared with traditional exercise outcomes such as VO 2 peak.…”