Document Type




Format of Original

6 p.

Publication Date




Source Publication

Pediatric Cardiology

Source ISSN


Original Item ID

doi: 10.1007/s00246-012-0217-8


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 VCO2 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.


Accepted version. Pediatric Cardiology, Vol. 33, No. 5 (June 2012): 791-796. DOI. © 2012 Springer International Publishing AG. Part of Springer Nature. Used with permission.

Michael J. Danduran was associated with Herma Heart Center, Children’s Hospital of Wisconsin, Milwaukee, WI at time of publication.

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