Background:Target CPET duration is ?8 ? 12 minutes, which can be influenced by the Watt increment protocol. No protocol selection calculation explicitly details suitability for paediatrics.
Aim: To determine if existing protocol calculation methods are appropriate in paediatrics
Methods: A retrospective evaluation of 55 paediatric CPETs was conducted.  A senior physiologist selected ramp protocol based on age and disclosed activity levels. Calculated ramp protocols were then determined using the methods described by Cooper et al. (Exercising testing and interpretation 2010) and Radtke et al. (Eur Respir Rev 2019; 19). Calculated protocols were adjusted for the ±5W advisory.  Using Watts achieved during the original test, predicted test durations using calculated protocols (±5W) were determined.  The number of patients that would have performed an acceptable exercise test using at least one variation (calculated, ±5W) of each calculation was recorded.
Results: Physiologists achieved 43 tests within target duration (78.18%). The Cooper et al. (2010) calculation would have resulted in 19 patients achieving a CPET within target duration.  A ±5W adjustment increased this to 39 (70.90%).   The Radtke et al. (2019) calculation would have resulted in 13 patients achieving a CPET within target duration. A ±5W adjustment would have increased this to 32 (58.18%). The percentage of acceptable tests did not significantly differ when the cohort was separated into <12 and ?12yrs. 

Conclusion: The Cooper et al. (2010) calculation would have been most applicable to the cohort. Neither calculation resulted in a success rate >80%. Further investigation into paediatric specific calculations may improve success rates.