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Breath holding during intense exercise: arterial blood gases, pH, and lactate.

Seven healthy endurance-trained [maximal O2 uptake (VO2max) = 57.1 +/- 4.1 ml.kg-1.min-1)] female volunteers (mean age 24.4 +/- 3.6 yr) served as subjects in an experiment measuring arterial blood gases, acid-base status, and lactate changes while breath holding (BH) during intense intermittent exercise. By the use of a counterbalance design, each subject repeated five intervals of a 15-s on:30-s off treadmill run at 125% VO2max while BH and while breathing freely (NBH). Arterial blood for pH, PO2, PCO2, O2 saturation (SO2) HCO3, and lactate was sampled from a radial arterial catheter at the end of each work and rest interval and throughout recovery, and the results were analyzed using repeated-measures analysis of variance. Significant reductions in pHa (delta mean = 0.07, P less than 0.01), arterial PO2 (delta mean = 24.2 Torr, P less than 0.01), and O2 saturation (delta mean = 4.6%, P less than 0.01) and elevations in arterial PCO2 (delta mean = 8.2 Torr, P less than 0.01) and arterial HCO3 (delta mean = 1.3 meq/l, P = 0.05) were found at the end of each exercise interval in the BH condition. All of the observed changes in arterial blood gases and acid-base status induced by BH were reversed during the rest intervals. During recovery, significantly (P less than 0.025) greater levels of arterial lactate were found in the BH condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis, Respiratory↗

Breathing pattern during maximal exercise and during submaximal exercise with hypercapnia.

During progressive exercise ventilation (VI) initially increases through increases in both tidal volume (VT) and respiratory frequency (f) but at high levels of exercise further increases in VI are almost completely due to increases in f and a VT plateau is seen. We wished to determine whether the presence of the VT plateau is due to a tachypneic influence related to very high levels of exercise or whether it represents a stereotypic response of the respiratory system at high levels of VI. We therefore compared breathing pattern in six subjects during maximal incremental exercise (ME) with that in the same subjects when similar levels of VI were obtained by a combination of submaximal exercise and hypercapnia (E/CO2). A VT plateau was seen in all ME and E/CO2 tests. There was no significant difference in the level of the VT plateau between the ME (2.93 +/- 0.17 liters) and E/CO2 (2.97 +/- 0.12 liters) tests. We conclude that the presence and level of the VT plateau during ME is not due to a tachypneic stimulus related to very high levels of exercise but is a function of the level of VI.

Adult↗

Exercise and sleep-disordered breathing: an association independent of body habitus.

STUDY OBJECTIVES: The degree to which physical exercise habits are related to sleep-disordered breathing is not known. We sought to investigate the association between a single-item exercise question and laboratory-assessed sleep-disordered breathing. DESIGN: A population-based cross-sectional epidemiologic study of adults measured the association between exercise and sleep-disordered breathing. Hours of weekly planned exercise were assessed by questionnaire. Sleep-disordered breathing was assessed by 18-channel in-laboratory polysomnography and characterized by the apnea-hypopnea index. SETTING: Polysomnography was conducted at the University of Wisconsin General Clinical Research Center sleep laboratory. PATIENTS AND PARTICIPANTS: Participants included 1104 men and women, aged 30 to 60 years, enrolled in the Wisconsin Sleep Cohort Study. MEASUREMENTS AND RESULTS: Associations were modeled using linear and logistic regression, adjusting for body mass index, skinfold measurements, age, sex, and other covariates. Adjusted mean (95% confidence interval) apnea-hypopnea index was 5.3 (4.4, 6.2) events per hour for participants who exercised 0 hours per week; 3.9 (2.8, 5.0) events per hour for those with 1 to 2 hours of exercise; 3.2 (2.2, 4.2) events per hour for those with 3 to 6 hours of exercise; and 2.8 (1.0, 4.6) for those with > 7 hours of exercise (P trend < .001). Similarly, the odds of having moderate or worse sleep-disordered breathing (apnea-hypopnea index > 15 events per hour) significantly decreased with increasing level of exercise. CONCLUSION: Independent of measures of body habitus, lack of exercise was associated with increased severity of sleep-disordered breathing.

Adult↗

A rehabilitation program for improving exercise tolerance of patients with chronic lung disease.

A Chronic Chest Disease Rehabilitation Program has been developed in the Toronto General Hospital to improve exercise tolerance in very disabled patients. The most important part of the program is physical conditioning using mainly a motor-driven treadmill. The treadmill exercise is done breathing room air or, in the case of the most disabled patients, an oxygen-enriched gas mixture. Other exercise includes riding a stationary bicycle, going up and down stairs, and turning a wheel by hand. Other aspects of the program are breathing exercises, inhalation therapy using an ultrasonic nebulizer, chest physiotherapy, and patient education. The importance of a team approach with encouragement, enthusiasm and demonstration of steady progress is emphasized.

Breathing Exercises↗

P0.1 during exercise in normal subjects breathing mixtures of gas with varying densities.

BACKGROUND AND AIM: The aim of the study was to re-examine the occlusion pressure measured simultaneously in the mouth (P0.1) and the oesophagus (Poes.1) during exercise in normal subjects submitted to different gas mixtures. METHODS: 7 healthy men breathing random gas mixtures containing 21% oxygen with either by 79% helium (He-O2) or sulphur hexafluoride (SF6-O2) and room-air, were studied during a steady-state 90w exercise performed on a cyclo-ergometer. Ventilatory parameters were derived from the flow signal recorded by a pneumotachograph calibrated with the different gas mixtures. Three pressure transducers (mouth, eosophageal and gastric) were checked to have iso-time identical responses up to 4Hz. P0.1, Poes.1, deltaPoes (difference in oesophageal pressure between end-inspiratory and end-expiratory levels) and deltaPdi (variation of transdiaphragmatic pressure between end-inspiratory and end-expiratory levels) were measured. RESULTS: Hyperventilation associated with a similar deltaPoes/deltaPdi but a lower P0.1/deltaPdi ratio was observed in He-O2 breathing compared to SF6-O2 and air. Variable time delays between oesophageal and mouth pressures were observed during air and SF6-O2. Whatever the condition involved, no change was detected in the shape of the inspiratory pressure during the occlusion manoeuvres. CONCLUSIONS: He-O2 breathing probably induced a change in the shape of the pressure wave later on in the inspiratory phase, making P0.1 not representing the total inspiratory drive. On the contrary in air and SF6-O2 conditions, P0.1 seemed to remain a useful tool for looking at the output of the respiratory controller.

Adult↗

Exercise training in patients with chronic airways obstruction.

Some studies concerning the effects of specific and non-specific techniques of respiratory muscle training and new strategies in exercise training of both skeletal and respiratory muscles, are reviewed. Breathing and exercise training show some evidence of improved gas exchange. Breathing through an inspiratory resistance has some advantages but also disadvantages. This technique has caused immediate hypoxaemia and pulmonary arterial hypertension in one third of the subjects studied. High intensity exercise with correspondingly high levels of ventilation may induce improvements in ventilatory muscle function. Two new techniques are described: the "above anaerobic threshold 40 min constant exercise" and the "45 min square-wave endurance exercise test" (SWEET), simulating an interval-training session. The effects on the cardiorespiratory, metabolic, arterial blood gases and acid base balance responses, were measured in normal subjects and in patients with chronic airway obstruction (CAO). After training, the magnitude of ventilation (VE) reduction was correlated with the reduction in end-exercise lactate. In addition, maximal ventilation and maximal oxygen consumption (VO2max) can increase after training. Finally, an interesting hypothesis is proposed about the use of arm-training.

Aged↗