Griffith GJ; Feinberg School of Medicine, Chicago, IL
Wang AP; Liem RI; Carr MR; Corson T; Ward K

Journal of Pediatrics. 264:113770, 2024 Jan.

OBJECTIVE: To develop reference values for cardiorespiratory fitness, as
quantified by peak oxygen uptake (VO2peak) and treadmill time, in patients
aged 6 through 18 years referred for cardiopulmonary exercise testing
(CPET).
STUDY DESIGN: We reviewed a clinical pediatric CPET database for fitness
data in children aged 6-18 years with no underlying heart disease. CPET
was obtained via the Bruce protocol utilizing objectively confirmed
maximal effort via respiratory exchange ratio. Fitness data (VO2peak and
treadmill test duration) were analyzed to determine age- and sex-specific
reference values for this pediatric cohort.
RESULTS: Data from 2025 pediatric CPETs (53.2% female) were included in
the analyses. VO2peak increased with age in males, but not females.
Treadmill test duration increased with age in both males and females.
Fitness was generally higher in males when compared with females in the
same age groups.
CONCLUSIONS: Our study provides extensive reference values for both
VO2peak and total treadmill test time via the Bruce protocol for a
pediatric population without known cardiac disease. Furthermore, the
inclusion of objectively confirmed maximal exercise effort increases
confidence in these findings compared with prior studies in this area.
Clinicians performing CPET in pediatric populations can utilize these
reference