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Ventilatory Efficiency in Children and Adolescents: A Systematic Review
Paloma Lopes Francisco Parazzi1, Fernando Augusto de Lima Marson2, Maria Angela Gonçalves de Oliveira Ribeiro1
1Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
Insights
Ventilatory efficiency (VE/VCO2) is crucial for heart failure prognosis in adults. This review found limited studies on its use in children and adolescents, highlighting a need for more research in pediatric populations.
Area of Science:
- Pediatric Cardiology
- Cardiorespiratory Physiology
- Exercise Testing
Background:
- The ventilatory efficiency index (VE/VCO2) is a gold standard for heart failure prognosis in adults.
- Limited research exists on VE/VCO2 application in pediatric and adolescent populations.
Purpose of the Study:
- To systematically review scientific evidence on the VE/VCO2 index in pediatric and adolescent patients.
- To assess the current understanding of VE/VCO2's role in evaluating, monitoring, and predicting outcomes in young individuals.
Main Methods:
- Systematic literature review using keywords VE/VCO2, children, and adolescents.
- Searched PEDro and PubMed/MedLine databases for clinical trials published between 1987 and 2014.
- Included studies involving individuals up to 25 years of age.
Main Results:
- Initial search yielded 95 articles; 12 were excluded based on relevance or age criteria.
- 58 duplicate articles were removed, resulting in a final sample of 32 studies.
- The included studies encompassed healthy children and those with various diseases.
Conclusions:
- There is a scarcity of research on cardiorespiratory assessment using ventilatory efficiency in young populations.
- Elevated VE/VCO2 values are linked to poorer prognoses, indicating reduced pulmonary perfusion and cardiac output.
Introduction:
The index of ventilatory efficiency (VE/VCO2) obtained by the progressive exercise test has been considered the gold standard in the prognosis of adults with heart failure, but few studies have evaluated this approach in children.
Objective:
To verify the scientific evidence about the VE/VCO2 in pediatric and adolescents patients.
Methods:
A systematic literature review was carried out using the key words VE/VCO2, children, and adolescents using the PEDro and PubMed/MedLine databases. Clinical trials published from 1987 to 2014, including children, adolescents, and young adults up to 25 years, addressing the VE/VCO2 index as a method of evaluation, monitoring, and prognosis were considered.
Results:
Initially, 95 articles were found; 12 were excluded as the title/abstract did not contain the VE/VCO2 index or because they included patients greater than 25 years of age. From the remaining 83, 58 were repeated between the databases. The final sample consisted of 32 studies including healthy children and children with respiratory and other diseases.
Conclusion:
There are few studies involving cardiorespiratory assessment by ventilatory efficiency. The studies highlight the fact that high VE/VCO2 values are associated with a worse prognosis of patients due to the relationship with the decrease in pulmonary perfusion and cardiac output.
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