Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study

Introduction Cardiopulmonary exercise testing (CPET) provides a series of biomarkers, such as peak oxygen uptake, which could assess the development of disease status in interstitial lung disease (ILD). However, despite use in research and clinical settings, the feasibility of CPET in this patient g...

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Main Authors: Michael Gibbons, Alexander Spiers, Craig Williams, Owen Tomlinson, Anna Duckworth, Laura Markham, Rebecca Wollerton, Bridget Knight, Chris Scotton
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/8/1/e000793.full
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spelling doaj-d996498f12ea4550a76000e1a38472352021-08-10T11:30:45ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-08-018110.1136/bmjresp-2020-000793Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB studyMichael Gibbons0Alexander Spiers1Craig Williams2Owen Tomlinson3Anna Duckworth4Laura Markham5Rebecca Wollerton6Bridget Knight7Chris Scotton8Academic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKSport and Health Science, University of Exeter, Exeter, UKSport and Health Science, University of Exeter, Exeter, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKInstitute of Biomedical & Clinical Science, College of Medicine & Health, University of Exeter, Exeter, UKAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation Trust, Exeter, UKIntroduction Cardiopulmonary exercise testing (CPET) provides a series of biomarkers, such as peak oxygen uptake, which could assess the development of disease status in interstitial lung disease (ILD). However, despite use in research and clinical settings, the feasibility of CPET in this patient group has yet to be established.Methods Twenty-six patients with ILD (19 male) were recruited to this study. Following screening for contraindications to maximal exercise, participants underwent an incremental CPET to volitional exhaustion. Feasibility of CPET was assessed by the implementation, practicality, acceptability and demand, thus providing clinical-driven and patient-driven information on this testing procedure.Results Of the 26 recruited participants, 24 successfully completed at least one CPET, with 67/78 prospective tests being completed. Contraindications included hypertension, low resting oxygen saturation and recent pulmonary embolism. Of the CPETs undertaken, 63% successfully reached volitional exhaustion, with 31% being terminated early by clinicians due to excessive desaturation. Quantitative and qualitative feedback from participants revealed a positive experience of CPET and desire for it to be included as a future monitoring tool.Conclusion CPET is feasible in patients with ILD. Identification of common clinical contraindications, and understanding of patient perspectives will allow for effective design of future studies utilising CPET as a monitoring procedure.https://bmjopenrespres.bmj.com/content/8/1/e000793.full
collection DOAJ
language English
format Article
sources DOAJ
author Michael Gibbons
Alexander Spiers
Craig Williams
Owen Tomlinson
Anna Duckworth
Laura Markham
Rebecca Wollerton
Bridget Knight
Chris Scotton
spellingShingle Michael Gibbons
Alexander Spiers
Craig Williams
Owen Tomlinson
Anna Duckworth
Laura Markham
Rebecca Wollerton
Bridget Knight
Chris Scotton
Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
BMJ Open Respiratory Research
author_facet Michael Gibbons
Alexander Spiers
Craig Williams
Owen Tomlinson
Anna Duckworth
Laura Markham
Rebecca Wollerton
Bridget Knight
Chris Scotton
author_sort Michael Gibbons
title Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
title_short Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
title_full Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
title_fullStr Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
title_full_unstemmed Feasibility of cardiopulmonary exercise testing in interstitial lung disease: the PETFIB study
title_sort feasibility of cardiopulmonary exercise testing in interstitial lung disease: the petfib study
publisher BMJ Publishing Group
series BMJ Open Respiratory Research
issn 2052-4439
publishDate 2021-08-01
description Introduction Cardiopulmonary exercise testing (CPET) provides a series of biomarkers, such as peak oxygen uptake, which could assess the development of disease status in interstitial lung disease (ILD). However, despite use in research and clinical settings, the feasibility of CPET in this patient group has yet to be established.Methods Twenty-six patients with ILD (19 male) were recruited to this study. Following screening for contraindications to maximal exercise, participants underwent an incremental CPET to volitional exhaustion. Feasibility of CPET was assessed by the implementation, practicality, acceptability and demand, thus providing clinical-driven and patient-driven information on this testing procedure.Results Of the 26 recruited participants, 24 successfully completed at least one CPET, with 67/78 prospective tests being completed. Contraindications included hypertension, low resting oxygen saturation and recent pulmonary embolism. Of the CPETs undertaken, 63% successfully reached volitional exhaustion, with 31% being terminated early by clinicians due to excessive desaturation. Quantitative and qualitative feedback from participants revealed a positive experience of CPET and desire for it to be included as a future monitoring tool.Conclusion CPET is feasible in patients with ILD. Identification of common clinical contraindications, and understanding of patient perspectives will allow for effective design of future studies utilising CPET as a monitoring procedure.
url https://bmjopenrespres.bmj.com/content/8/1/e000793.full
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