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Biomedical subjects

K J Killian

Publications and source records attributed to K J Killian.

At least 37 records · Page 2Linked to original sources
PubMed1991

Breathing during prolonged exercise in humans.

1. Six normal subjects cycled to endurance or for 60 min at four work rates (WR 1-4): mean of 34% working capacity (93 watts for 60 min); 43% (120 watts for 56 min); 63% (177 watts for 37 min); and 84% (233 watts for 12 min), to determine how breathing pattern and dyspnoea change during prolonged activity. Four to six minutes were allowed to establish steady state and subsequent changes were considered to be endurance related. 2. Dyspnoea (Borg scale, 0-10) increased with the duration of activity at all work rates. 3. Ventilation (VE) did not change at WR1; increased from 44 to 47 l min-1 at WR2; from 60 to 88 l min-1 at WR3; and from 111 to 132 l min-1 at WR4. Dyspnoea was significantly and independently related to ventilation and duration of activity: dyspnoea = 0.004 VE1.36 time 0.25 (r = 0.81; partial F 202 and 26 respectively). 4. Inspiratory resistance did not increase at any work rate. Dynamic elastance remained constant during WR1, WR2 and WR3 but increased from 7.4 to 9.1 cmH2O l-1 during WR4. 5. Peak inspiratory pressure did not increase, and the increase in VE was accomplished by an increased breathing frequency without change in duty cycle. 6. Duration of activity is an important contributor to dyspnoea independent of changes in respiratory muscle contractile activity.

Adult↗
PubMed1991

Effort and dyspnoea during work of varying intensity and duration.

This study quantified the separate contributions of the intensity of exercise and its duration to muscular effort and dyspnoea during cycle ergometry. Six normal subjects estimated the perceived intensity (Borg scale 0-10) of peripheral muscular effort and dyspnoea during incremental exercise to their maximum work capacity (Wcap). On separate days, the same subjects exercised to endurance or 60 min at work rates rated for leg effort on the initial incremental test as: 2 ("slight", 33.1 +/- 1.45% Wcap) (mean +/- SE); 3 ("moderate", omission 83.6 +/- 3.87% Wcap). Perceived leg effort increased by a factor of 4.4 (2(2.13)) with a doubling of work rate and by 1.3 (2(0.39)) with a doubling of duration, as expressed by: Leg effort = k x %Wcap2.13 x Time0.39 (r2 = 0.87) Perceived dysponea increased 5.3-fold with a doubling of work rate and by 1.4-fold with a doubling of duration: Dysponea = k x %Wcap2.41 x Time0.47 (r2 = 0.75) Changes in work intensity, rather than duration, dominated symptom magnitudes such that in the performance of a given task, halving the intensity and doubling the duration of activity reduces the maximal intensity of muscular effort and dyspnoea to less than a third.

Adult↗
PubMed1990

Methacholine airway responsiveness decreases during exercise in asthmatic subjects.

In many asthmatic subjects, bronchoconstriction develops 2 to 5 min after exercise, reaches a maximum at approximately 10 min, and declines over the next 60 min. However, bronchodilation is typically observed during and immediately after exercise. We measured the bronchoconstrictor responses to increasing concentrations of inhaled methacholine at rest and during two levels of exercise in seven asthmatic subjects to determine the protection against bronchoconstriction afforded by exercise. On the first day, an incremental Stage 1 exercise test was performed to determine the work capacity (Wcap) of each subject. On the second, third, and fourth days, methacholine was inhaled at rest or during steady-state exercise at one-third or two-thirds of Wcap. The bronchoconstrictor response to methacholine was significantly reduced during exercise (p less than 0.0001). The concentration of methacholine required to produce a 20% reduction in FEV1 (PC20) increased from 2.80 mg/ml (%SEM, 1.62) at rest to 7.29 mg/ml (%SEM, 1.43) during exercise at one-third Wcap, and to 31.03 mg/ml (%SEM, 1.74) during exercise at two-thirds Wcap (p less than 0.001). This study has demonstrated that there is greater than tenfold protection against bronchoconstriction by methacholine during exercise, and the magnitude of the protection depends on the intensity of exercise performed. The mechanism of this protection is not known, but may have clinical utility.

Adolescent↗
PubMed1989

An approach to dyspnea in cancer patients.

There are many potential causes of dyspnea in the patient with cancer. Ultimately, a sense of increased respiratory effort is common to all of these diverse situations. An organized approach to dyspnea in the cancer patient is presented based on psychophysical principles, and treatment modalities are suggested.

Airway Resistance↗
PubMed1989

Influence of age and stature on exercise capacity during incremental cycle ergometry in men and women.

The present study re-evaluated the accuracy of standards for maximal exercise capacity (Wcap) recently reported from our laboratory by examining the interaction between height and age on Wcap achieved and predicted in 1,071 subjects (732 males and 339 females). They underwent an incremental exercise test on a cycle ergometer using the same incremental protocol and exercise mode as the previous study, and were retrospectively judged to be normal. Although Wcap predicted was either not significantly different (males) or underestimated Wcap by less than 5% (females, p less than 0.05), significant differences were found in subjects at the extremes of the population ranges for height and age. The influences of age 9yr) and height (m) were found to be nonlinear and interactive, as described by the equations: Males: Wcap = 1506*Ht2.70*Age-0.46(r = 0.78) (lower limit 81% pred) Females: Wcap = 969*Ht2.80*Age-0.43(r = 0.77) (lower limit 79% pred) Wcap (kpm/min) predicted by these equations was compared to Wcap achieved by the 100 subjects who took part in the original study; no significant differences were found (paired t test, p less than 0.05). The interactive influences of age and height expressed by the equations are more plausible from a biological point of view than the linear, additive relationships previously described. The equations should be more reliable than previous equations for patients referred for exercise testing.

Aging↗
PubMed1988

Inspiratory muscles during exercise: a problem of supply and demand.

The capacity of inspiratory muscles to generate esophageal pressure at several lung volumes from functional residual capacity (FRC) to total lung capacity (TLC) and several flow rates from zero to maximal flow was measured in five normal subjects. Static capacity was 126 +/- 14.6 cmH2O at FRC, remained unchanged between 30 and 55% TLC, and decreased to 40 +/- 6.8 cmH2O at TLC. Dynamic capacity declined by a further 5.0 +/- 0.35% from the static pressure at any given lung volume for every liter per second increase in inspiratory flow. The subjects underwent progressive incremental exercise to maximum power and achieved 1,800 +/- 45 kpm/min and maximum O2 uptake of 3,518 +/- 222 ml/min. During exercise peak esophageal pressure increased from 9.4 +/- 1.81 to 38.2 +/- 5.70 cmH2O and end-inspiratory esophageal pressure increased from 7.8 +/- 0.52 to 22.5 +/- 2.03 cmH2O from rest to maximum exercise. Because the estimated capacity available to meet these demands is critically dependent on end-inspiratory lung volume, the changes in lung volume during exercise were measured in three of the subjects using He dilution. End-expiratory volume was 52.3 +/- 2.42% TLC at rest and 38.5 +/- 0.79% TLC at maximum exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Respiratory muscles and dyspnea.

This article reviews the classical basis on which dyspnea is identified and quantified. The sensation or sensations of discomfort experienced during breathing are then viewed using a background of sensory physiology. Exploiting psychophysical techniques, the origin of the sensation of discomfort is viewed within the constraints of the presently-known sensory structures. The contribution of these sensory structures to the quality and quantity of discomfort is suggested, indicating the central role played by the respiratory muscles.

Dyspnea↗
PubMed1987

Effect of thoracoabdominal breathing patterns on inspiratory effort sensation.

The respiratory sensations evoked by added inspiratory loads are currently thought to be largely mediated by the activity of the inspiratory muscles. Because of the differences in proprioceptors and in afferent and efferent innervations among the inspiratory muscles, we hypothesized that the sensation evoked by a given load would be different when the motor command is directed mainly to rib cage muscles or mainly to the diaphragm. To test this hypothesis, we studied six normal subjects breathing against several inspiratory resistances while emphasizing the use of rib cage muscles, or the diaphragm, or a combination of both. At the end of 10 loaded breaths the subjects rated the perceived magnitude of inspiratory effort on a Borg scale. A linear and unique relationship (r = 0.96 +/- 0.02; P less than 0.001) was found between the sensation and esophageal pressure (Pes) in the three thoracoabdominal breathing patterns. We conclude that the level of Pes, whether generated mainly by the rib cage muscles or the diaphragm, is the main variable related to the sensation of inspiratory effort under external inspiratory loads.

Abdomen↗
PubMed1986

Breathlessness during exercise with and without resistive loading.

The purpose of this study was to quantify the intensity of breathlessness associated with exercise and respiratory resistive loading, with the specific purpose of isolating the quantitative contributions of inspiratory pressure, length, velocity, and frequency of inspiratory muscle shortening and duty cycle to breathlessness. The intensity of inspiratory pressure was quantified by measurement of estimated esophageal pressure (Pes = pressure at the mouth plus lung pressure), the extent of shortening by tidal volume (VT), and the velocity of shortening by inspiratory flow rate (VI). Six normal subjects underwent five incremental (100 kpm X min-1 X min-1) exercise tests on a cycle ergometer to maximum capacity. The first and last test were unloaded and the intervening tests were performed with external added resistances of 33, 57, and 73 cm H2O X l-1 X s in random order. The resistances were selected to provide a range of pressures, tidal volumes, flow rates, and patterns of breathing. At rest and at the end of each minute during exercise the subjects estimated the intensity of breathlessness (psi) by selecting a number ranging from 0 to 10 (Borg rating scale, 0 indicating no appreciable breathlessness and 10 the maximum tolerable sensation). Breathlessness was significantly and independently related to Pes (P less than 0.0001), VI (P less than 0.0001), frequency of breathing (fb) (P less than 0.01), and duty cycle [ratio of inspiratory duration to total breath duration (TI/TT)] (P less than 0.01): psi = 0.11 Pes + 0.61 VI + 1.99 TI/TT + 0.04 fb - 2.60 (r = 0.83). The results suggest that peak pressure (tension), VI (velocity of inspiratory muscle shortening), TI/TT, and fb contribute independently and collectively to breathlessness. The perception of respiratory muscle effort is ideally suited to subserve this sensation. The neurophysiological mechanism purported is a conscious awareness of the intensity of the outgoing motor command by means of corollary discharge within the central nervous system.

Adult↗
PubMed1986

Breathlessness and exercise in patients with cardiorespiratory disease.

Previous studies have led to the revival of the hypothesis that breathlessness is the perception of respiratory muscle effort and is present when the tension developed by muscles increases, when the muscles are weak, or when both conditions are present simultaneously. Using a category scale, the intensity of breathlessness was measured in 20 subjects (2 normal subjects and 18 patients) undergoing an incremental exercise test (50 to 100 kpm/min) to maximal capacity. The patients were selected to provide a heterogeneous group of pulmonary diseases, obesity, muscular weakness, and cardiac disease, with a wide variability in exercise capacity (250 to 1,900 kpm/min) and severity of dyspnea. Maximal inspiratory pressure (MIP), pleural pressure (Ppl), the extent of shortening of the inspiratory muscles as indicated by the tidal volume expressed as a percent of vital capacity (VT/VC), the rate of shortening as indicated by flow rate, the frequency of contraction as indicated by breathing frequency (fb), and the duty cycle (TI/Ttot) were measured throughout exercise to assess their relative contribution to the intensity of breathlessness. Using multifactorial analysis, the perception of breathlessness was significantly (p less than 0.01) related to the Ppl, inspiratory flow rate (VI), VT/VC, TI/Ttot, and fb. A multiple linear regression equation that included all these variables explained 69% of the variance, with no single factor being identified as uniquely predominant: Breathlessness = 3.0 (Ppl/MIP) + 1.2 (VI) + 4.5 (VT/VC) + 0.13 (fb) + 5.6 TI/Ttot) - 6.2 (R = 0.83). The intensity of effort required to produce a given pressure increases when the muscle is weak, when the velocity of contraction increases, or when the muscle shortens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

The relation of inspiratory effort sensation to fatiguing patterns of the diaphragm.

Tension in the respiratory muscles and the subsequent intrathoracic subatmospheric pressure swing plays a role in respiratory effort sensation. However, the role of a diaphragmatic fatiguing process in the genesis of this sensation has not been examined. Therefore, we studied the effect of fatiguing contractions of the diaphragm on inspiratory effort sensation (IES) in 6 normal male subjects during inspiratory resistive loading. Four diaphragmatic fatiguing and 4 diaphragmatic nonfatiguing patterns were developed for each subject. These 8 patterns were imposed in random order for 10 breaths (50 s) with duty cycle and tidal volume fixed. The presence or absence of a diaphragmatic fatiguing process was confirmed by analysis of the high to low ratio of the electromyographic signal from an esophageal electrode. Subjects scored their IES immediately after each run using a modified Borg scale. There was a very strong correlation between IES and esophageal pressure (Pes) expressed as a percentage of maximal inspiratory esophageal pressure (Pes/Pesmax %) (r = 0.88, p less than 0.001). However, IES was independent of the presence of a diaphragmatic fatiguing pattern. Furthermore, there was no difference in the slope or intercept of the regression lines relating IES to Pes/Pesmax % when fatiguing and nonfatiguing runs were analyzed separately. We conclude that the severity of IES during resistive loading held for 50 s is independent of the development of diaphragmatic fatigue.

Adult↗
PubMed1985

Inspiratory muscle forces and endurance in maximum resistive loading.

The ability of the respiratory muscles to sustain ventilation against increasing inspiratory resistive loads was measured in 10 normal subjects. All subjects reached a maximum rating of perceived respiratory effort and at maximum resistance showed signs of respiratory failure (CO2 retention, O2 desaturation, and rib cage and abdominal paradox). The maximum resistance achieved varied widely (range 73-660 cmH2O X l-1 X s). The increase in O2 uptake (delta Vo2) associated with loading was linearly related to the integrated mouth pressure (IMP): delta Vo2 = 0.028 X IMP + 19 ml/min (r = 0.88, P less than 0.001). Maximum delta Vo2 was 142 ml/min +/- SD 68 ml/min. There were significant (P less than 0.05) relationships between the maximum voluntary inspiratory pressure against an occluded airway (MIP) and both maximum IMP (r = 0.80) and maximum delta Vo2 (r = 0.76). In five subjects, three imposed breathing patterns were used to examine the effect of different patterns of respiratory muscle force deployment. Increasing inspiratory duration (TI) from 1.5 to 3.0 and 6.0 s, at the same frequency of breathing (5.5 breaths/min) reduced peak inspiratory pressure and increased the maximum resistance tolerated (190, 269, and 366 cmH2O X l-1 X s, respectively) and maximum IMP (2043, 2473, and 2913 cmH2O X s X min-1, but the effect on maximum delta Vo2 was less consistent (166, 237, and 180 ml/min). The ventilatory endurance capacity and the maximum O2 uptake of the respiratory muscles are related to the strength of the inspiratory muscles, but are also modified through the pattern of force deployment.

Adult↗
PubMed1985

Effect of frequency on perceived magnitude of added loads to breathing.

Using open-magnitude scaling, six normal subjects estimated the perceived magnitude of a range of added elastic loads (20-76 cmH2O/l), applied for a sequence of five breaths, at frequencies varying from 5 to 26.4 breaths/min. Two experiments were performed. In the first, frequency was increased by a reduction in expiratory duration (TE), and the duty cycle (ratio of inspiratory duration to total breath duration, TI/TT) ranged between 0.10 and 0.52. The perceived magnitude psi increased significantly with the peak airway pressure (Pm) (P less than 0.0001) but did not reach conventional significance with frequency (fb) (P = 0.15): psi = K0Pm1.23fb0.07 (r = 0.911). However, the sensory magnitude increased significantly as the duty cycle increased (P less than 0.01), but when it was included, the magnitude decreased minimally with frequency (P less than 0.01): psi = K0Pm1.3fb-0.97 TI/TT1.14 (r = 0.92). In the second experiment the duty cycle (TI/TT) was kept constant [(0.43 +/- 0.008 (SE)] and frequency (5-26.4 breaths/min) increased at the expense of shortening both TI and TE. The perceived magnitude of the added elastances decreased with the increase in frequency. However, when the perceived magnitude was corrected for the duration of inspiration, which is known to increase the sensory magnitude, psi = K0Pm1.3TI0.56, the sensory magnitude increased significantly with frequency (P less than 0.001): psi/TI0.56 = K0Pm1.21fb0.28 (r = 0.773). The decrease in inspiratory duration had a greater quantitative effect decreasing sensory magnitude than frequency had on increasing the magnitude. The effect of increasing frequency is complex and depends on the simultaneous intensity, duration of inspiratory pressure, and the duty cycle.

Adult↗
PubMed1985

The objective measurement of breathlessness.

Both direct and indirect psychophysical methods can be used to measure breathlessness. With indirect methods, detection thresholds can be defined. Direct methods are easier to apply and give more information than indirect methods. Direct methods include interval (partition) and ratio scales, which are easy to apply; both have advantages and disadvantages. The selection of scale depends largely on the question addressed. For comparison across individuals or for the measurement of absolute magnitude (however imprecise), simple category scales are adequate and useful. Open magnitude scaling is best used to define the stimulus parameters influencing perceptual magnitude. Comparison across groups or individuals using exponents as an index of perceptual sensitivity should be interpreted with caution. Where possible, alternative methods should be used to validate differences found. The age-old bias against sensory measurement may be in part our inability to understand the sensory mechanisms and have little to do with the validity of the measurements.

Airway Resistance↗
PubMed1984

Effect of increased lung volume on perception of breathlessness, effort, and tension.

By the addition of externally added elastic loads at both functional residual capacity (FRC) and increased lung volume, increased respiratory muscle effort, tension, and breathlessness were induced in normal subjects. The magnitude of each of these sensations was estimated using the psychophysical technique of category scaling (Med. Sci. Sports Exercise 14: 377-381, 1982). The tidal volume, inspiratory time, and breathing frequency were kept constant to avoid variability in sensation due to these factors. The perceived magnitude of effort and breathlessness increased significantly as the inspiratory pressure and lung volume increased (P less than 0.05). The magnitude of perceived tension increased as the inspiratory pressure increased (P less than 0.05) but not as lung volume increased. To validate these results, the subjects estimated the perceived magnitude of a series of static inspiratory occlusion pressures at both lung volumes using open-magnitude scaling and sensory matching. The perceived magnitude of effort increased significantly as the pressure increased and as the lung volume increased (P less than 0.05). To match the perceived effort required to produce the target pressures at FRC, the subjects reproduced pressures. These were not significantly different. However, to match the effort required to produce the target pressures at increased lung volume, the pressures reproduced at FRC were significantly greater (P less than 0.05). The results suggest that the sensations of breathlessness and effort are psychophysically the same, whereas tension is perceived by a different sensory mechanism.

Adult↗
PubMed1984

Alveolar gas exchange during exercise: a single-breath analysis.

Changes in expired alveolar O2 and CO2 were measured breath-by-breath in six healthy male subjects (mean age 30 yr, mean weight 80 kg) at rest, 600 kpm/min, and 1,200 kpm/min. Changes were expressed in relation to expired volume (liters) and time (s) and separated into an initial dead-space component using the Fowler method applied to expired CO2 and O2, and alveolar slope. The alveolar slopes with respect to time (dPACO2, dPAO2, Torr/s) increased in relation to CO2 output (VCO2, 1/min, STPD) and O2 intake (VO2, 1/min, STPD) but were reduced by increasing tidal volume (VT, liters, BTPS): dPACO2 = 2.7 + 4.6(VCO2) - 1.9(VT) (r = 0.97); and dPAO2 = 2.3 + 5.5(VO2) - 1.9(VT) (r = 0.96). From the alveolar slopes, tidal volume, and airway dead-space volume, mean expired alveolar PO2 and PCO2 (PAO2, PACO2) were calculated. There was no change in arterialized capillary PCO2 (PaCO2) between rest (38.9 +/- 0.66 Torr) and heavy exercise (38.2 +/- 2.18 Torr), but mean PACO2 rose from 36.7 +/- 0.55 to 40.8 +/- 1.67 Torr during heavy exercise. There was no change in arterialized capillary (mean = 84.3 +/- 0.7 Torr) or alveolar (mean = 107.2 +/- 1.03 Torr) PO2. Exercise increases the fluctuations in alveolar gas composition leading to discrepancies between the PCO2 in mean alveolar gas and arterial blood to an extent that is dependent on VCO2 and VT.

Adult↗