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DOI: 10.1055/a-2191-0518
Practical Aspects of Cardiopulmonary Exercise Testing in Children
Abstract
The use of cardiopulmonary exercise testing (CPET) in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Furthermore, CPET helps evaluate exercise performance in children with chronic (lung/heart) diseases. For instance, it can ascertain any adverse reaction to exercise and estimate the effects of specific treatment measures. It affords a global assessment of the pathophysiological patterns, responses and abnormalities to exercise that is inadequately reflected by resting lung function and/or cardiac function assessment. Clinical interpretation of the results of a CPET in pediatrics requires specific knowledge regarding pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child’s medical condition or disability.
Publikationsverlauf
Eingereicht: 05. Januar 2023
Angenommen: 02. Oktober 2023
Accepted Manuscript online:
12. Oktober 2023
Artikel online veröffentlicht:
29. November 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,
Germany
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References
- 1 Ross R, Blair SN, Arena R. et al. Importance of assessing cardiorespiratory fitness in clinical practice: A case for fitness as a clinical vital sign: A scientific statement from the american heart association. Circulation 2016; 134: e653-e699
- 2 Raghuveer G, Hartz J, Lubans DR. et al. Cardiorespiratory fitness in youth: an important marker of health: A scientific statement from the american heart association. Circulation 2020; 142: e101-e118
- 3 Bongers BC, Hulzebos HJ, van Brussel M. et al. Pediatric norms for cardiopulmonary exercise testing. 2nd edition. ‘s-Hertogenbosch. the Netherlands: Uitgeverij BOXPress; 2014
- 4 Müller J, Hager A, Diller G-P. et al. Peak oxygen uptake, ventilatory efficiency and QRS-duration predict event free survival in patients late after surgical repair of tetralogy of Fallot. Int J Cardiol 2015; 196: 158-164
- 5 Duppen N, Takken T, Hopman MT. et al. Systematic review of the effects of physical exercise training programmes in children and young adults with congenital heart disease. Int J Cardiol 2013; 168: 1779-1787
- 6 Radtke T, Crook S, Kaltsakas G. et al. ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. Eur Respir Rev 2019; 28: 180101
- 7 Hebestreit H, Arets HG, Aurora P. et al. Statement on exercise testing in cystic fibrosis. Respiration 2015; 90: 332-351
- 8 Karila C, de Blic J, Waernessyckle S. et al. Cardiopulmonary exercise testing in children: an individualized protocol for workload increase. Chest 2001; 120: 81-87
- 9 Bruce RA, Blackmon JR, Jones JW. et al. Exercise testing in adult normal subjects and cardiac patients. Pediatrics 1963; 32: 742-756
- 10 Kotte EM, de Groot JF, Bongers BC. et al. Validity and reproducibility of a new treadmill protocol: The fitkids treadmill test. Med Sci Sports Exerc 2015; 47: 2241-2247
- 11 Dubowy KO, Baden W, Bernitzki S. et al. A practical and transferable new protocol for treadmill testing of children and adults. Cardiol Young 2008; 18: 615-623
- 12 Kotte EMW, de Groot JF, Winkler AMF. et al. Fitkids treadmill test: Clinical utility and factors associated with its use among physical therapists. Phys Ther 2019; 99: 428-439
- 13 Kotte EM, de Groot JF, Bongers BC. et al. Fitkids treadmill test: Age- and sex-related normative values in dutch children and adolescents. Phys Ther 2016; 96: 1764-1772
- 14 Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 1990; 16: 55-58
- 15 Parazzi PL, Marson FA, Ribeiro MA. et al. Ventilatory abnormalities in patients with cystic fibrosis undergoing the submaximal treadmill exercise test. BMC Pulm Med 2015; 15: 63
- 16 Schonbeck Y, Talma H, van Dommelen P. et al. Increase in prevalence of overweight in Dutch children and adolescents: A comparison of nationwide growth studies in 1980, 1997 and 2009. PLoS One 2011; 6: e27608
- 17 Königstein K, Klenk C, Rossmeissl A. et al. The obesity factor: how cardiorespiratory fitness is estimated more accurately in people with obesity. Obesity 2018; 26: 291-298
- 18 Waterfall JL, Burns P, Shackell D. et al. The risks of applying normative values in paediatric cardiopulmonary exercise testing: A case report. ERJ Open Res 2020; 6: 00333-02020
- 19 Dumitrescu D, Rosenkranz S. Graphical data display for clinical cardiopulmonary exercise testing. Ann Am Thorac Soc 2017; 14: S12-S21
- 20 Vecchiato M, Ermolao A, Zanardo E. et al. Overshoot of the respiratory exchange ratio during recovery from maximal exercise testing in young patients with congenital heart disease. Children (Basel) 2023; 10: 521
- 21 Neder JA. Cardiopulmonary exercise testing applied to respiratory medicine: Myths and facts. Respir Med 2023; 214: 107249
- 22 Kaafarani M, Schroer C, Takken T. Reference values for blood pressure response to cycle ergometry in the first two decades of life: comparison with patients with a repaired coarctation of the aorta. Expert Rev Cardiovasc Ther 2017; 15: 945-951
- 23 Nordlinder JH, Ekstrom M, Brudin L. et al. Paediatric reference values for the work rate-indexed systolic blood pressure response during exercise. Eur J Prev Cardiol 2022; 29: e283-e285
- 24 Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 1985; 1986: 2020-2027
- 25 Cerezuela-Espejo V, Courel-Ibanez J, Moran-Navarro R. et al. The relationship between lactate and ventilatory thresholds in runners: Validity and reliability of exercise test performance parameters. Front Physiol 2018; 9: 1320
- 26 Seiler KS, Kjerland GO. Quantifying training intensity distribution in elite endurance athletes: is there evidence for an “optimal” distribution?. Scand J Med Sci Sports 2006; 16: 49-56
- 27 Van Brussel M, Bongers BC, Hulzebos EHJ. et al. A systematic approach to interpreting the cardiopulmonary exercise test in pediatrics. Pediatr Exerc Sci 2019; 1-10
- 28 Takken T, Hulzebos HJ, Schmitz M. et al. Is BMI associated with cardiorespiratory fitness? A cross-sectional analysis among 8470 apparently healthy subjects aged 18–94 years from the low-lands fitness registry. J Sci Sport Exerc 2022; 4: 283-289
- 29 Loftin M, Sothern M, Abe T. et al. Expression of VO2peak in Children and Youth, with Special Reference to Allometric Scaling. Sports Med 2016; 46: 1451-1460
- 30 Wasserman K. Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012