Abstract
Pediatric patients are often referred to cardiopulmonary exercise testing (CPET) laboratories for assessment of exercise-related symptoms. For clinicians to understand results in the context of performance relative to peers, adequate fitness-based prediction equations must be available. However, reference equations for prediction of peak oxygen uptake (VO2peak) in pediatrics are largely developed from field-based testing, and equations derived from CPET are primarily developed using adult data. Our objective was to develop a pediatric reference equation for VO2peak. Clinical CPET data from a validation cohort of 1,383 pediatric patients aged 6 to 18 years who achieved a peak respiratory exchange ratio ≥1.00 were analyzed to identify clinical and exercise testing factors that contributed to the prediction of VO2peak from tests performed using the Bruce protocol. The resultant prediction equation was applied to a cross-validation cohort of 1,367 pediatric patients. Exercise duration, gender, weight, and age contributed to the prediction of VO2peak, generating the following prediction equation: (R2 = 0.645, p <0.001, standard error of the estimate =" 6.19 ml/kg/min):" vo2peak (ml kg min)="16.411+" 3.423 (exercise duration [minutes]) - 5.145 (gender [0 =" male," 1 =" female])" - 0.121 (weight [kg]) + 0.179 (age [years]). this equation was stable across the age range included in the present study, with differences ≤0.5 ml kg min between mean measured and predicted vo2peak in all age groups. in conclusion, this study represents what we believe is the largest pediatric cpet-derived vo2peak prediction effort to date, and this vo2peak prediction equation provides clinicians who perform and interpret exercise tests in pediatric patients with a resource with which to better quantify fitness when cpet is not available.>
