title: Ventilatory Efficiency in Children and Adolescents: A Systematic Review.
abstract: BACKGROUND
  The index of ventilatory efficiency (VE/VCO2) obtained by the progressive exercise test has been considered the gold standard in the prognosis of adults with heart failure, but few studies have evaluated this approach in children.
  
  
  OBJECTIVE
  To verify the scientific evidence about the VE/VCO2 in pediatric and adolescents patients.
  
  
  METHODS
  A systematic literature review was carried out using the key words VE/VCO2, children, and adolescents using the PEDro and PubMed/MedLine databases. Clinical trials published from 1987 to 2014, including children, adolescents, and young adults up to 25 years, addressing the VE/VCO2 index as a method of evaluation, monitoring, and prognosis were considered.
  
  
  RESULTS
  Initially, 95 articles were found; 12 were excluded as the title/abstract did not contain the VE/VCO2 index or because they included patients greater than 25 years of age. From the remaining 83, 58 were repeated between the databases. The final sample consisted of 32 studies including healthy children and children with respiratory and other diseases.
  
  
  CONCLUSIONS
  There are few studies involving cardiorespiratory assessment by ventilatory efficiency. The studies highlight the fact that high VE/VCO2 values are associated with a worse prognosis of patients due to the relationship with the decrease in pulmonary perfusion and cardiac output.
authors.affiliation: Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
authors.forename: Paloma Lopes Francisco
authors.initials: PL
authors.lastname: Parazzi
authors.affiliation: Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil ; Department of Medical Genetics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
authors.forename: Fernando Augusto de Lima
authors.initials: FA
authors.lastname: Marson
authors.affiliation: Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
authors.forename: Maria Angela Gonçalves de Oliveira
authors.initials: MA
authors.lastname: Ribeiro
authors.affiliation: State University of Santa Catarina, Center of Physical Education and Sports, Coqueiros, 88080-350 Florianópolis, SC, Brazil.
authors.forename: Camila Isabel Santos
authors.initials: CI
authors.lastname: Schivinski
authors.affiliation: Department of Clinical Medics, Faculty of Medical Sciences, State University of Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
authors.forename: Jose Dirceu
authors.initials: JD
authors.lastname: Ribeiro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005080:Exercise Test / Q000379:methods*; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D012123:Pulmonary Ventilation / Q000502:physiology*; D055815:Young Adult