ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases.
Thomas RadtkeSarah CrookGeorgios KaltsakasZafeiris LouvarisDanilo BertonDonald S UrquhartAsterios KampourasRoberto A RabinovichSamuel VergesDimitris KontopidisJeanette BoydThomy ToniaDaniel LangerJana De BrandtYvonne M J GoërtzChris BurtinMartijn A. SpruitDionne C W BraekenSauwaluk DachaFrits M E FranssenPierantonio LavenezianaErnst EberThierry TroostersJose Alberto NederMilo Alan PuhanRichard CasaburiIoannis VogiatzisHelge HebestreitPublished in: European respiratory review : an official journal of the European Respiratory Society (2019)
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.
Keyphrases
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- physical activity
- public health
- randomized controlled trial
- prognostic factors
- cross sectional
- systematic review
- clinical trial
- depressive symptoms
- blood pressure
- high intensity
- peritoneal dialysis
- mental health
- patient reported outcomes
- clinical practice
- social support
- resistance training
- artificial intelligence
- quality improvement
- machine learning
- big data
- drug induced