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Inter-institutional differences in clinical pediatric exercise laboratory (CPEL) practices may affect consistency of patient care and efficacy of multi-center research. Purpose: To 1) describe current practices and procedures in CPELs; and 2) explore differences in CPELs that employ an exercise physiologist (ExP) to those that do not. Methods: A survey (min 37, max 68 items) was distributed to CPELs in the U.S and Canada focusing on three domains: 1) staffing (min 6, max 12 items); 2) volumes, reporting, and interpretation (min 12, max 22 items); and 3) procedures/protocols (min 19, max 34 items). Results: Of the n=73 responses, n=18 were excluded for being ineligible, not completing the survey, or were duplicated responses, producing a final sample of n=55. Most responses were from the U.S. (92.7%), represented a children’s hospital with university affiliation (83.6%), and reported to be cardiology specific (58.2%). ExPs are employed in 56.4% of CPELs (88.2% ExPs with master’s degree or higher). Physicians, cardiovascular techs, respiratory therapists, or nurses were responsible for conducting clinical exercise stress tests (ESTs) in CPELs without an ExP. Emergency life-support, professional, and clinical certifications were required in 92.3%, 27%, and 21.2% of CPELs, respectively. 9.6% of CPELS had no certification requirements. The median volume was 201-400 ESTs/yr. with 20% of the sample performing >800 ESTs/yr. Treadmill and cycle were the primary modalities (80% and 10% of ESTs, respectively). Institution specific exercise protocols were used in 20% of CPELs. 72% of CPELs provide services in addition to ESTs such as cardiac/pulmonary rehab. Non-parametric testing found that those CPELS with an ExP perform a higher volume of ESTs (p < 0.001), are more likely to perform metabolic ESTs (p=0.028), participate in more research (p < 0.001), and provide services in addition to ESTs (p=0.001). Conclusions: Inter-institutional differences in CPELs staffing and operation may warrant efforts for standardization.

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Practices And Procedures In Clinical Pediatric Exercise Laboratories In North America