Comparison of Exercise Protocols for Diagnosing Pediatric Unexplained Dyspnea on Exertion.

IF 1.4 4区 医学 Q3 PEDIATRICS
Elliott Brown, Karla Foster, Iesha Gover, Adam Powell, William D Hardie
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引用次数: 0

Abstract

Purpose: Clinicians evaluating pediatric patients with unexplained dyspnea on exertion (DOE) often obtain exercise testing with a treadmill-based exercise-induced bronchospasm (EIB) protocol measuring only changes in spirometry. We modified the EIB protocol to collect metabolic and lung volume endpoints as obtained in a cardiopulmonary exercise test (CPET). We tested the hypothesis that measuring metabolic data with the EIB protocol (EIB-CPET) would yield greater diagnostic information than the EIB protocol.

Methods: Exercise test diagnosis for healthy children with DOE referred to the pulmonary exercise lab from January 2011 through July 2023 were retrospectively compared between those performing either the EIB or EIB-CPET protocols.

Results: One hundred and twenty-seven patients with unexplained DOE were analyzed. Of the 72 patients tested on the EIB protocol, 49% had stridor and 5% with EIB. Of the 55 patients tested on the EIB-CPET protocol, 42% had stridor, 42% with normal physiologic limitation, 22% with dysfunctional breathing, 5% with deconditioning, 2% with EIB, and 2% with exercise-induced hypoxemia. Patients performing the EIB-CPET protocol had a significantly higher rate of any diagnosis compared with EIB (P = .0002).

Conclusions: There is a greater diagnostic yield in children with unexplained DOE performing the EIB-CPET protocol compared with patients performing the EIB protocol.

用于诊断小儿原因不明的劳力性呼吸困难的运动方案比较。
目的:临床医生在对不明原因的用力呼吸困难(DOE)儿科患者进行评估时,通常采用基于跑步机的运动诱发支气管痉挛(EIB)方案进行运动测试,该方案仅测量肺活量的变化。我们修改了 EIB 方案,以收集心肺运动测试 (CPET) 中获得的代谢和肺活量终点。我们测试了一个假设,即用 EIB 方案(EIB-CPET)测量代谢数据会比 EIB 方案产生更多的诊断信息:方法:我们对 2011 年 1 月至 2023 年 7 月期间转诊至肺功能锻炼实验室的健康 DOE 儿童的锻炼测试诊断结果进行了回顾性比较:对127名原因不明的DOE患者进行了分析。在 72 位接受 EIB 方案测试的患者中,49% 有喘鸣,5% 有 EIB。在 55 名接受 EIB-CPET 方案测试的患者中,42% 有喘鸣,42% 有正常生理限制,22% 有呼吸功能障碍,5% 有衰竭,2% 有 EIB,2% 有运动引起的低氧血症。与 EIB 相比,执行 EIB-CPET 方案的患者确诊率明显更高(P = 0.0002):结论:与执行EIB方案的患者相比,执行EIB-CPET方案的不明原因DOE患儿的诊断率更高。
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来源期刊
Pediatric Exercise Science
Pediatric Exercise Science 医学-生理学
CiteScore
2.80
自引率
0.00%
发文量
33
审稿时长
>12 weeks
期刊介绍: Pediatric Exercise Science is a journal committed to enriching the scientific knowledge of exercise during childhood and adolescence. To this end it publishes information that contributes to an understanding of (a) the unique aspects of the physiologic, physical, biochemical, and psychologic responses of children to exercise, (b) the role of exercise in the treatment of pediatric chronic diseases, (c) the importance of physical activity in the prevention of illness and preservation of wellness, and (d) the means by which participation in sports may be made safer and more enjoyable for children and youth. Consideration will be given for publication of work by various methodologies consistent with the scientific approach. Besides original research, the journal includes review articles, abstracts from other journals, book reviews, and editorial comments. Pediatric Exercise Science encourages the expression of conflicting opinions regarding children and exercise by providing a forum for alternative viewpoints. At the same time it serves as a means of accumulating a base of research information that will allow application of experimental data to clinical practice. The scientific disciplines contributing to this body of knowledge are diverse. Therefore it is the purpose of this journal to provide a common focus for disseminating advances in the science of exercise during childhood. In doing so, the journal allows the opportunity for cross-fertilization of ideas between disciplines that will potentiate the growth of knowledge in this field. Pediatric Exercise Science seeks to stimulate new ideas regarding exercise in children and to increase the awareness of scientists, health care providers, and physical educators of the importance of exercise during childhood.
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