Article: Maximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategy

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TitleMaximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategy
AuthorsMcManus, A1
Leung, M1
Issue Date2000
PublisherAdis International Ltd. The Journal's web site is located at http://sportsmedicine.adisonline.com/pt/
CitationSports Medicine, 2000, v. 29 n. 4, p. 229-244 [How to Cite?]
AbstractImplicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much inter-individual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation.
ISSN0112-1642
2011 Impact Factor: 5.155
2011 SCImago Journal Rankings: 0.228
DC Field
Value
dc.contributor.authorMcManus, A
dc.contributor.authorLeung, M
dc.date.accessioned2010-09-06T09:35:06Z
dc.date.available2010-09-06T09:35:06Z
dc.date.issued2000
dc.description.abstractImplicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much inter-individual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationSports Medicine, 2000, v. 29 n. 4, p. 229-244 [How to Cite?]
dc.identifier.epage244
dc.identifier.hkuros52781
dc.identifier.isiWOS:000086579000002
dc.identifier.issn0112-1642
2011 Impact Factor: 5.155
2011 SCImago Journal Rankings: 0.228
dc.identifier.issue4
dc.identifier.openurl
dc.identifier.pmid10783899
dc.identifier.scopuseid_2-s2.0-0033997388
dc.identifier.spage229
dc.identifier.urihttp://hdl.handle.net/10722/87835
dc.identifier.volume29
dc.languageeng
dc.publisherAdis International Ltd. The Journal's web site is located at http://sportsmedicine.adisonline.com/pt/
dc.publisher.placeNew Zealand
dc.relation.ispartofSports Medicine
dc.titleMaximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: The development of an appropriate test strategy
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong