Search PubMed⌕ Search

Biomedical subjects

B J Whipp

Publications and source records attributed to B J Whipp.

At least 91 records · Page 5Linked to original sources

A respiratory gas exchange simulator for routine calibration in metabolic studies.

We have developed a method for simulating respiratory gas exchange for on-line calibration of metabolic measurement systems. It utilizes a pump which intakes a mixture of atmospheric air and a known flow of precision-analysed calibration gas (21% CO2, 79% N2). It expels the resulting mixture with flow wave form and profiles of gas concentration which closely resemble those of normal expiration. Control of the calibration mixture's inflow allows the investigator to set any desired metabolic rate regardless of the minute ventilatory rate. This separation of metabolic from ventilatory rates provides a stringent test of the computational performance of the respiratory gas exchange measurement systems. The apparatus can reproduce any range of respiratory and metabolic performance (currently ranging from 0.2-5 l.min-1 O2 uptake and CO2 output) with accuracy +/- 2%.

Calibration↗

Gas exchange theory and the lactic acidosis (anaerobic) threshold.

The physiological requirements of performing exercise above the anaerobic threshold are considerably more demanding than for lower work rates. Lactic acidosis develops at a metabolic rate that is specific to the individual and the task being performed. Although numerous pyruvate-dependent mechanisms can lead to an elevated blood lactate, the increase in lactate during muscular exercise is accompanied by an increase in lactate/pyruvate ratio (i.e., increased NADH/NAD ratio). This is typically caused by an inadequate O2 supply to the mitochondria. Thus, the anaerobic threshold can be considered to be an important assessment of the ability of the cardiovascular system to supply O2 at a rate adequate to prevent muscle anaerobiosis during exercise testing. In this paper, we demonstrate, with statistical justification, that the pattern of arterial lactate and lactate/pyruvate ratio increase during exercise evidences threshold dynamics rather than the continuous exponential increase proposed by some investigators. The pattern of change in arterial bicarbonate (HCO3-) and pulmonary gas exchange supports this threshold concept. To estimate the anaerobic threshold by gas exchange methods, we measure CO2 output (VCO2) as a continuous function of O2 uptake (VO2) (V-slope analysis) as work rate is increased. The break-point in this plot reflects the obligate buffering of increasing lactic acid production by HCO3-. The anaerobic threshold measured by the V-slope analysis appears to be a sensitive index of the development of metabolic acidosis even in subjects in whom other gas exchange indexes are insensitive, owing to irregular breathing, reduced chemoreceptor sensitivity, impaired respiratory mechanics, or all of these occurrences.

Acidosis, Lactic↗

Physiological determinants of pulmonary gas exchange kinetics during exercise.

We consider how the optimal selection of the profile of imposed work rate, coupled with rigorous, statistically justified analysis of the pattern of the pulmonary gas exchange response, makes it possible to assemble a control model incorporating the proportional role of the muscle, circulation, and gas stores. Gains, time constants, and delays may be assigned to the components of the response and its linearity assessed. These techniques also allow the investigator to examine the features of poorly understood and even unexpected response patterns. Recent interest in the analysis of the non-steady state of exercise-in normal subjects and in patients with gas exchange defects-has led to an improved understanding of the sub-threshold dynamics. At work rates above the lactate threshold, the more complex kinetics are to date poorly described, and hence poorly understood, remaining a fertile area for the application of control-systems techniques to exercise.

Exercise↗

Breathing-valve encumbrance and arterial blood gas and acid-base status in exercise in man.

It has been suggested that the mouth-piece-breathing valve assemblies commonly used in laboratory investigations of ventilatory control may influence regulation of arterial blood gas and acid-base status during exercise. To examine this hypothesis, 10 healthy males each underwent two incremental cycle-ergometer tests (15 W min-1) to the limit of tolerance: one was conducted free of breathing apparatus; the other utilized a mouth-piece (with noseclip) connected to a low-resistance turbine volume sensor. The order was randomly assigned and tests were separated by a 2 h recovery. Blood sampled from an indwelling brachial artery catheter at rest and every 30 W during exercise was analyzed for PCO2, PO2, pH and HCO-3. Maximum power was not different between the two tests. Furthermore, no systematic effect of the assembly could be discerned on PaCO2, PaO2 or pHa over the entire range of power. We therefore conclude that although ventilation and its pattern may be affected by laboratory breathing apparatus, such encumbrance (if of low resistance and dead space) does not influence blood gas and acid-base regulation during exercise.

Acid-Base Equilibrium↗

Fitness as a determinant of oxygen uptake response to constant-load exercise.

Exercise performed above the lactate threshold (OLa) produces a slowly-developing phase of oxygen uptake (VO2) kinetics which elevates VO2 above that predicted from the sub-OLa VO2-work rate relationship. This phenomenon has only been demonstrated, to date, in subjects who were relatively homogeneous with respect to fitness. This investigation therefore examined whether this behaviour occurred at a given absolute VO2 or whether it was a characteristic of supra-OLa exercise in a group of subjects with over a threefold range of OLa (990-3000 ml O2.min-1) and peak VO2 (1600-5260 ml O2.min-1). Twelve healthy subjects performed: 1) exhausting incremental cycle ergometer exercise for estimation of OLa (OLa) and peak VO2, and 11) a series of constant-load tests above and below OLa for determination of the VO2 profile and efficiency of work. During all tests expired ventilation, VO2 and carbon dioxide production were monitored breath-by-breath. The efficiency of work determined during incremental exercise (28.1 +/- 0.7%, means +/- SE, n = 12) did not differ from that determined during sub-OLa constant-load exercise (27.4 +/- 0.5%, p greater than 0.05). For constant-load exercise, VO2 rose above that predicted, from the sub-OLa VO2-work rate relationship, for all supra-OLa work rates. This was evident above 990 ml O2.min-1 in the least fit subject but only above 3000 ml O2.min-1 in the fittest subject. As a consequence the efficiency of work was reduced from 27.4 +/- 0.5% for sub-OLa exercise to 22.6 +/- 0.4% (p less than 0.05) at the lowest supra-OLa work rate (i.e. OLa + 20 W, on average).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Ventilatory control of the 'isocapnic buffering' region in rapidly-incremental exercise.

During incremental exercise PCO2 does not fall for several work rates ('isocapnic buffering') above the anaerobic threshold (theta an). We explored this apparent lack of compensatory hyperventilation in 24 normal subjects who underwent incremental cycling (15 W/min) to exhaustion. Ventilation, pulmonary gas exchange, and end-tidal gas tensions were computed breath-by-breath. In 10 subjects, arterial blood was sampled every 2 min throughout the test. Our findings confirmed the 'isocapnic' supra-theta an region, but it consistently followed a progressive increase of PETCO2 in the sub-theta an region. A similar pattern was evident for PaCO2. The leveling-out of PETCO2 and PaCO2 was a result of breathing frequency increasing at theta an, thereby shortening expiratory time, i.e., progressively truncating the continued increase in the alveolar PCO2 slope. Consequently 'isocapnic buffering' during incremental exercise does not reflect PCO2 which continues to be regulated at a constant sub-theta an value. Rather it reflects a ventilatory response to the metabolic acidosis which levels a systematically-rising phase of PETCO2 and PaCO2, largely through a change in breathing pattern. Respiratory compensation, as reflected by a declining PETCO2 and PaCO2, does not occur typically for a subsequent 2 or more minutes.

Acid-Base Equilibrium↗

Effects of peripheral and central chemoreflex activation on the isopnoeic rating of breathing in exercising humans.

1. Respiratory sensation during exercise is generally considered to be related to respiratory mechanical factors which may be manifest as an abnormal relationship between the force applied to the lungs and chest wall and the resulting motion (if any); that is, a 'length-tension' inappropriateness (Campbell & Howell, 1963). This suggests that there should be a direct correlation between ventilation (VE) and the associated intensity of the perceived sensation, such that the sensation associated with a particular level of VE should remain essentially constant regardless of the source of respiratory stimulation. 2. In order to establish whether certain respiratory stimuli might be 'dyspnoeagenic' (i.e. capable of evoking an intensity of respiratory sensation out of proportion to their influence on VE), we investigated the influence of both peripheral chemoreflex activation (induced by isocapnic hypoxia) and central chemoreflex activation (induced by hypercapnic hyperoxia) on the intensity of respiratory sensation in seven healthy adults during moderate cycle ergometer exercise (i.e. below the lactate threshold, theta 1ac). 3. In each test, an 'isopnoea' was established for which a particular level of VE was sustained over a prolonged period (approximately 30 min) while the proportional contributions to the ventilatory drive from either exercise and the peripheral chemoreflex or from exercise and the central chemoreflex were slowly altered to new stable levels, without the subject's knowledge, VE, tidal volume, inspiratory and expiratory durations, mean inspiratory flow, and end-tidal PCO2 and PO2 (PET,CO2, PET,O2) were monitored breath-by-breath. The intensity of respiratory sensation was rated with a visual analogue scale. 4. Isopnoeic ratings of respiratory sensation were systematically greater for peripheral chemoreflex activation by isocapnic hypoxia during exercise at 50% theta 1ac (for which the degree of peripheral chemoreflex activation, estimated by hyperoxic transition or 'Dejours' testing, averaged approximately 23% of the total VE), compared to 90% theta 1ac during isocapnic hyperoxia. Ratings during exercise at 50% theta 1ac for central chemoreflex activation by hypercapnic hyperoxia were not systematically different from 90% theta 1ac during isocapnic hyperoxia, however. 5. As VE was stable throughout each isopnoea and the MVV (maximum voluntary ventilation) was uninfluenced by the test condition, the dyspnoea index (VE x 100/MVV) was not affected. Breathing pattern was also unaffected. 6. We conclude that in normal subjects exercising moderately, activation of the peripheral chemoreceptors by isocapnic hypoxia evokes an intensity of respiratory sensation which is out of proportion to that evoked by an isopnoeic stimulation of the central chemoreceptors with hypercapnic hyperoxia at the same level of exercise.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Model implications of gas exchange dynamics on blood gases in incremental exercise.

In humans, arterial PCO2 (PaCO2) has been demonstrated to be regulated at or near resting levels in the steady state of moderate exercise (i.e., for work rates not associated with a sustained lactic acidosis). To determine how PaCO2 might be expected to behave under the nonsteady-state conditions of incremental exercise testing, the influence of the dynamic characteristics of the primary variables that determine PaCO2 was explored by means of computer modeling. We constructed a dynamic model that utilized previously reported experimental estimates for the kinetic response parameters of ventilation (VE) and CO2 output (VCO2). In response to incremental work rate forcings, the model yielded an increase in PaCO2, which reflected the disparity between the VE and VCO2 time constants; this hypercapnic condition was maintained despite VE and VCO2 both increasing linearly with respect to the input work rate profile. The degree of hypercapnia increased with the rate of the incremental forcing, reaching 9 Torr for a 50-W/min forcing. In conclusion, therefore, sustained increases in PaCO2 during nonsteady-state incremental exercise should be interpreted with caution, because this is the predicted response even in subjects with normal ventilatory control and lung function.

Carbon Dioxide↗

Respiration during recovery from exercise: effects of trapping and release of femoral blood flow.

To investigate the contribution of vascular and metabolic stimuli to the sustained hyperpnea after exercise, the respiratory effects of obstructing and then releasing the femoral blood flow were recorded in 15 normal volunteers during recovery from steady-state cycle exercise (80 W). Obstruction was achieved using cuffs around the upper thighs, inflated for the first 2 min of recovery to a pressure of 200 mmHg. Cuff inflation significantly reduced ventilation during recovery compared with control (P less than 0.001); the subsequent release of pressure was accompanied by an increase in ventilation (averaging 3.2 l/min), which began on the first breath after release. This preceded a rise in end-tidal CO2 (maximum 8.3 Torr increase), which first became significant on the fourth breath after release and led to a further rise in ventilation. The first-breath increase in ventilation after cuff release persisted, although slightly attenuated (averaging 2.5 l/min), in additional experiments with inspired O2 fraction of 1.0. The pattern of ventilatory response was also similar when the experiments were performed with 5% CO2 in air as the inspirate. The immediate rise in ventilation on cuff release, together with the persistent response on 100% O2, suggests that the vascular changes resulting from cuff release exert an influence on ventilation independent of the effects of released metabolites on the known chemoreceptors. The persistence of the response on 5% CO2 indicates that CO2-sensitive lung afferents do not have a major role in these responses.

Adolescent↗

Control of blood-gas and acid-base status during isometric exercise in humans.

1. At a given level of pulmonary gas exchange, ventilation (VE) is appreciably higher during isometric exercise than during isotonic exercise. It is presently not clear whether the resultant hypocapnia represents a compensatory hyperventilation for an arterial metabolic acidaemia or whether it might reflect a primary respiratory alkalaemia. 2. To resolve this issue, five subjects performed isometric leg exercise designed to induce exhaustion in ca. 5 min and, on a separate occasion, ca. 8 min. VE, CO2 output (VCO2), O2 uptake (VO2) and end-tidal gas tensions (PET,CO2, PET,O2) were measured breath-by-breath during exercise and recovery; arterialized venous blood (drawn from the dorsum of the heated hand) was sampled frequently and analysed for PCO2, PO2, pH, bicarbonate and lactate. These response profiles were compared with those resulting from exhausting bouts of isotonic leg exercise (cycle ergometry) of similar duration. 3. The isotonic exercise induced a metabolic (lactic) acidaemia with partial respiratory compensation. In contrast, isometric exercise consistently resulted in a respiratory alkalaemia, with little or no increase of blood [lactate]. At the end of the isometric exercise, VE fell abruptly and then rose again after a short interval (20 s, on average). This secondary stimulation presumably reflected the acid-base consequences of the increased blood [lactate] (3-5 mM, on average) which occurred in the recovery phase. 4. We therefore conclude that a primary respiratory alkalaemia occurs during isometric exercise, and that this results from ventilatory stimulation at a time when the 'exercise' metabolites are trapped within the contracting muscles as a consequence of impeded blood flow. The initial rapid reduction of ventilation which occurred at the cessation of the isometric exercise is consistent with a washing-out of 'hyperpnoea-inducing' metabolites from the muscles. Allowing for transit to the central circulation, the reduced ventilation is subsequently supplemented by a powerful humoral drive to breathe which results in a further hyperpnoea and secondary hypocapnia. Because of its latency, we hypothesize that this secondary hypocapnia is of peripheral chemoreceptor origin. 5. The ventilatory response profile for isometric exercise, and the subsequent recovery phase, supports the contention that both the exercising muscles and the peripheral chemoreceptors can be important sites for inducing hyperpnoea in humans.

Acid-Base Equilibrium↗

Control of ventilation during exercise in patients with central venous-to-systemic arterial shunts.

The diversion of systemic venous blood into the arterial circulation in patients with intracardiac right-to-left shunts represents a pathophysiological condition in which there are alterations in some of the potential stimuli for the exercise hyperpnea. We therefore studied 18 adult patients with congenital (16) or noncongenital (2) right-to-left shunts and a group of normal control subjects during constant work rate and progressive work rate exercise to assess the effects of these alterations on the dynamics of exercise ventilation and gas exchange. Minute ventilation (VE) was significantly higher in the patients than in the controls, both at rest (10.7 +/- 2.4 vs. 7.5 +/- 1.2 l/min, respectively) and during constant-load exercise (24.9 +/- 4.8 vs. 12.7 +/- 2.61 l/min, respectively). When beginning constant work rate exercise from rest, the ventilatory response of the patients followed a pattern that was distinct from that of the normal subjects. At the onset of exercise, the patients' end-tidal PCO2 decreased, end-tidal PO2 increased, and gas exchange ratio increased, indicating that pulmonary blood was hyperventilated relative to the resting state. However, arterial blood gases, in six patients in which they were measured, revealed that despite the large VE response to exercise, arterial pH and PCO2 were not significantly different from resting values when sampled during the first 2 min of moderate-intensity exercise. Arterial PCO2 changed by an average of only 1.4 Torr after 4.5-6 min of exercise. Thus the exercise-induced alveolar and pulmonary capillary hypocapnia was of an appropriate degree to compensate for the shunting of CO2-rich venous blood into the systemic arterial circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Influence of inspiratory assistance on ventilatory control during moderate exercise.

In five healthy subjects, we studied the effects of controlled mechanical unloading of the respiratory system on ventilatory control during moderate exercise, utilizing a modified positive-pressure ventilator (IEEE Trans. Biomed. Eng. BME-33: 361-365, 1986). We were especially interested in whether isocapnia was maintained when a portion of the normal ventilatory response to constant-load cycling was subserved by the ventilator. The mechanical unloading was achieved by "assisting" airflow throughout inspiration in a constant proportion to instantaneous flow. Two modest degrees of assistance (A1 = 1.5 and A2 = 3.0 cmH2O X l-1 X s) were imposed. The assistance caused minute ventilation (VE) to increase immediately (inspiratory time shortening and tidal volume rising) and end-tidal PCO2 (PETCO2) to fall. Some 10-15 s later, inspiratory occlusion pressure (P100) decreased, and in the new steady-state VE and PETCO2 were virtually restored to their control exercise levels. The modest residual hyperventilation [delta PETCO2 = -0.9 Torr (A1) and -1.6 Torr (A2)], which was not significant statistically, contrasted markedly with the much larger increase predicted for VE had there been no compensatory reduction in ventilatory drive (as evidenced by the fall in P100). Consistent with earlier studies utilizing resistive loading (J. Appl. Physiol. 35: 361-366, 1973 and Acta Physiol. Scand. 120: 557-565, 1984), these observations suggest that ventilatory drive during moderate exercise is controlled to compensate for modest changes in respiratory-mechanical load, so that VE is preserved at a level appropriate to metabolic rate or nearly so.

Adult↗

Effect of interbreath fluctuations on characterizing exercise gas exchange kinetics.

Breathing has inherent irregularities that produce breath-to-breath fluctuations ("noise") in pulmonary gas exchange. These impair the precision of characterizing nonsteady-state gas exchange kinetics during exercise. We quantified the effects of this noise on the confidence of estimating kinetic parameters of the underlying physiological responses and hence of model discrimination. Five subjects each performed eight transitions from 0 to 100 W on a cycle ergometer. Ventilation, CO2 output, and O2 uptake were computed breath by breath. The eight responses were interpolated uniformly, time aligned, and averaged for each subject; and the kinetic parameters of a first-order model (i.e., the time constant and time delay) were then estimated using three methods: linear least squares, nonlinear least squares, and maximum likelihood. The breath-by-breath noise approximated an uncorrelated Gaussian stochastic process, with a standard deviation that was largely independent of metabolic rate. An expression has therefore been derived for the number of square-wave repetitions required for a specified parameter confidence using methods b and c; method a being less appropriate for parameter estimation of noisy gas exchange kinetics.

Adult↗

Chemoreflex modulation of ventilatory dynamics during exercise in humans.

The precision of arterial blood gas homeostasis following a change of work rate depends on the response kinetics of ventilation. The carotid bodies (CB's) have been proposed as modulators of these kinetics. The present investigation was undertaken to determine whether the effect is specific to CB activation or whether other factors that augment the exercise hyperpnea would produce a similar response. We therefore established the effects of increased CB and central (C) chemoreflex activation on the inspired ventilatory (VI) dynamics for moderate-intensity cycling. Work tests were separately performed with air, 12% O2 to increase CB activity, 100% O2 to "abolish" CB activity, and CO2 in O2 to increase C activity. The time constant of the VI response was substantially shortened by hypoxia (40 s) compared with air breathing (58 s) and increased by 100% O2 (92 s) and, even more so, by CO2 in O2 (101 s). We conclude that increased carotid (but not central) chemoreflex responsiveness speeds the kinetics of the exercise hyperpnea by a process that is not merely the consequence of increased ventilatory drive.

Adult↗

Oxygen uptake kinetics and lactate concentration during exercise in humans.

For constant-load exercise of moderate intensity, oxygen uptake (VO2) increases monoexponentially, reaching a constant value within 3 min, i.e., steady state. However, at work rates associated with increased blood lactate, i.e., above the lactate threshold (LT), VO2 continues to increase slowly beyond 3 min; this delays or precludes steady state. We therefore correlated the characteristics of this slow phase of the VO2 kinetics with the increase in blood lactate during 6 randomized, constant-load cycle exercise tests in 6 normal men. One test was below and the others were at various levels above our gas exchange estimate of LT. The slow kinetic phase of VO2, characterized as the increase between the third and the sixth minute of exercise [delta VO2 (6-3)] or the third minute and termination of exercise [delta VO2 (term-3)], was linearly correlated with the blood lactate increase. The VO2 at termination of a given work rate above LT was greater than predicted from the sub-LT VO2 versus work-rate relationship. Work rates less than approximately 50% of the difference between VO2max and LT resulted in lactate and VO2 curves that reached recognizable asymptotes. At the higher work rates, both the lactate and VO2 curves continued to rise to the point of fatigue. We conclude that positive values for delta VO2 (6-3) and delta VO2(term-3) during constant-load exercise only occur at work rates above the LT, and the magnitudes of which are highly correlated with the increase in blood lactate.

Adult↗