Pediatric Cardiology

, Volume 33, Issue 5, pp 791–796 | Cite as

Near-Infrared Spectroscopic Monitoring During Cardiopulmonary Exercise Testing Detects Anaerobic Threshold

  • Rohit P. RaoEmail author
  • Michael J. Danduran
  • Rohit S. Loomba
  • Jennifer E. Dixon
  • George M. Hoffman
Original Article


Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2). Our specific aim was to predict anaerobic threshold (AT) during CPET noninvasively using two-site NIRS monitoring. Achievement of a practical noninvasive technology for estimating AT will increase the compatibility of CPET. Patients without structural or acquired heart disease were eligible for inclusion if they were ordered to undergo CPET by a cardiologist. Data from 51 subjects was analyzed. The ventilatory anaerobic threshold (VAT) was computed on \( {\text{V}}_{{{\text{CO}}_{2} }} \) and respiratory quotient post hoc using the standard V-slope method. The inflection points of the regional rSO2 time-series were identified as the noninvasive regional NIRS AT for each of the two monitored regions (cerebral and kidney). AT calculation made using an average of kidney and brain NIRS matched the calculation made by VAT for the same patient. Two-site NIRS monitoring of visceral organs is a predictor of AT.


NIRS Cardiopulmonary exercise testing Anaerobic threshold Noninvasive monitoring 



We acknowledge the invaluable logistical support and coordination of this research provided by Mary M. Krolikowski. Grant support came from Pilot Innovative Research Award, Children’s Research Institute, Children’s Health System, Milwaukee, WI.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Rohit P. Rao
    • 1
    Email author
  • Michael J. Danduran
    • 4
  • Rohit S. Loomba
    • 2
  • Jennifer E. Dixon
    • 4
  • George M. Hoffman
    • 3
  1. 1.Sections of Cardiology and Critical CarePhoenix Children’s HospitalPhoenixUSA
  2. 2.Department of PediatricsMedical College of WisconsinMilwaukeeUSA
  3. 3.Department of Anesthesia, Section of Pediatric AnesthesiaMedical College of WisconsinMilwaukeeUSA
  4. 4.Herma Heart CenterChildren’s Hospital of WisconsinMilwaukeeUSA

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