Exercise testing in children with respiratory diseases

CPET provides clinicians and researchers with a tool to evaluate medical complaints related to exercise, multi-organ function over time in specific disease states, and physical fitness. When performing CPET in children, it is important to consider the remarkable physiological, anatomical and psychological transformations due to growth, maturation and development affecting the physiology and the physiological response to exercise that occur during childhood and adolescence. In children, test performance will depend on exercise equipment and physiology sampling equipment that is easy for children to use and sensitive to the measurement of smaller absolute ventilatory signals. In children, test interpretation will depend on knowledge of the fairly constant HR response to exercise across age and sex, smaller stroke volume and VT, and higher arteriovenous O₂ difference in comparison with adults. With respect to specific respiratory diseases, exercise testing can document the severity of airflow decline in exercise-induced bronchoconstriction, the quantity of glottic and supraglottic obstruction in patients with exercise-induced laryngeal obstruction, and the severity of respiratory impairment in bronchopulmonary dysplasia and cystic fibrosis.