Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Respiratory System, MAXIMAL VOLUNTARY VENTILATION, OBSTRUCTIVE PULMONARY-DISEASE, RESPIRATORY GAS-EXCHANGE, VISUAL ANALOG SCALES, HEART-RATE RECOVERY, SCIENTIFIC STATEMENT, OXYGEN-UPTAKE, PULSE-OXIMETRY, PHYSIOLOGICAL-RESPONSES, NONINVASIVE ASSESSMENT, Chronic Disease, Clinical Protocols, Europe, Exercise Test, Humans, Lung Diseases, 1116 Medical Physiology, 3201 Cardiovascular medicine and haematology

Abstract:

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2-3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.