Centre for Anaesthesia Critical Care & Pain Medicine


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

The best way is to email ucl-tr.CPXref@nhs.net

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
Referral FormDownload the referral form
Patients: What does it involve for you ?

Patients please click here to see our YouTube guide!

Before the test- please

  • don't eat for 1 and an half hours
  • drink no coffee or tea for 4 hours- but do feel free to have unrestricted water
  • take all your normal medicines as usual
  • wear comfortable clothing and 'sensible' shoes

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.


The CPET tests are carried out at 3 sites;

UCLH at Westmorland Street - alternate Mondays in the 'Cystectomy Clinic'. Outpatients ground floor.

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


Rob Stephens, John Whittle, Nick Tetlow, Amy Dewar

Postal Address


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

Cardiopulmonary Exercise Testing, c/o ISEH, 

1st Floor, 

170 Tottenham Court Road, 

London, W1T 7HA


Professor Monty Mythen
Dr Gareth Ackland
Thank you to Dan Martin, and Professor Hugh Montgomery for valuable advice.

Dr Ramani Moonesinghe at SOURCE

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


Email   ucl-tr.CPXref@nhs.net

Rob Stephens at UCLH


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- we'll be in EPIC at UCLH

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

Here's the BJA Education guide to a 9 panel Plot 

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

Hear Amy Dewar talk about her role as a student

Contact Rob Stephens for more info


POETTS: Perioperative Exercise Testing and Training Society

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

Extreme Everest


on performing a CPET.

Hear Amy talk briefly about her time as a CPET student

Download Amy's CPET summary