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Cardio pulmonary exercise test: CPET

Aims: to accurately measure exercise capacity for clinical use and research

What is CPET ? Cardio pulmonary Exercise Testing (CPET) is a non-invasive simultaneous measurement of the cardiovascular and respiratory system during exercise to assess a patient’s exercise capacity.
How to refer

Please download + print/email this referral form  to ucl-tr.CPXref@nhs.net

Mobile Number 07849 016074

Landline 020 3447 2838

Why do a CPET ?

CPET is used for many specific reasons, but in general it can

  • help estimate risk for patients undergoing surgery
  • be useful in investigating breathlessness
  • be used in exercise programmes to increase fitness
   
Patients: What does it involve for you ?

Patients please click here to see our YOU tube guide!

Before the test- please don't eat for 2 hours and drink no coffee or tea for 4 hours. Take all your normal medicines as usual. 

When you arrive we will ask you about your medical history and what exercise you're normally able to do, and ask your permission to record your data for research and audit use.

We take baseline observations and a blood test. You wear a mask to allow us to measure the gas you breathe in and out.

Once seated on the bike, we ask you to start cycling. The bike then gets harder to cycle- and we ask you to carry on until you can't exercise any more. We record readings (such as heart rate) as you exercise.

The test gives a guide to your fitness and may be helpful in planning your treatment.

When 

The CPET tests are carried out at 3 sites;

University College London Hospital, Come to 1st floor podium in Clinic D 'preasessment'  

Alternate Mondays, every Thursday and Friday

UCLH at Westmorland Street - alternate Mondays in the 'Cystectomy Clinic'

The Royal Free Hospital testing Thursdays Come to 'PITU area 3 Lung Function Diagnostic Room, 2nd Floor' - Dr Dan Martin

Patients having surgery at The Whittington Hospital, Archway are tested at the UCL Hospitals or the Royal Free. 

Staff

Rob StephensDan Martin, Belinda Durey, Sarah Hayden, James Otto, David Bruce. 

Thank you to Dr Denny Levett, Professor Mike Grocott and Professor Hugh Montgomery for valuable advice. 

Gurinder Rayat was our student 2015-16, and Tapi Mafuva is with us until August 2017.

Postal Address

Please contact initially our email ucl-tr.CPXref@nhs.net or  Dan Martin or Rob Stephens

Cardiopulmonary Exercise Testing, c/o ISEH, 

1st Floor, 

170 Tottenham Court Road, 

London, W1T 7HA

Collaborators

Professor Monty Mythen
Dr Gareth Ackland

Dr Ramani Moonesinghe at SOURCE

The CPEX team is a multidisciplinary venture started by the Centre for Altitude Space and Extreme Environment Medicine group UCL

Contact

Rob Stephens at UCLH, Dan Martin at RFH or

Email   ucl-tr.CPXref@nhs.net

Mobile   07849 016074

Landline 020 3447 2838

UCLH: Clinic A, Room 4, Surgical Reception, University College Hospital

RFH: PITU area 3 Lung Function Diagnostic Room, 2nd Floor, Royal Free Hospital

Teaching

We often have visiting teams in the clinic. Do view the videos above before. Please email ucl-tr.CPXref@nhs.net  for availability.

During the CPET test, once consent has been taken and the preliminary tests (Hb, spirometry) are complete, the patient undertakes a 'ramped protocol test' on a cycle ergometer.

We attach a 12 lead ECG, blood pressure cuff, saturation probe and a soft rubber face mask with a turbine to measure the expired gases before the test starts. The patient then rests for 3 minutes then begins to cycle. After 3 minutes of unloaded cycling the resistance begins to increase. The patient continues pedalling at 60rpm until they can no longer cycle, unless they have chest pains, feel discomfort or rarely if the physiologist stops the test.

During every test exercise physiologists trained to carry out the CPET are present, in conjunction with a doctor.

Reports from the test are written up and sent back to the medical team.

Download a brief introduction to CPET by Adam Jackson

Here's a great introduction to CPET interpretation from the University of Washington

Our 

CPET Setup - what we do before the test     

CPET for Patients - what to tell patients coming for a test

CPET Introduction - outlines a test  

CPET Analysis - more information that the 'introduction' podcast

CPET Critique overview by Professor Mike Grocott

Contact Rob Stephens for more info

Links

POETTS: Perioperative Exercise Testing and Training Society

We recommend courses on the website www.pcpet.co.uk and EBPOM

www.case-medicine.co.uk

www.xtreme-everest.co.uk

The ATS guidelines on performing a CPEx test