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Espinosa-Ramírez M, Riquelme S, Araya F, Rodríguez G, Figueroa-Martínez F, Gabrielli L, Viscor G, Reid WD, Contreras-Briceño F. Effectiveness of Respiratory Muscles Training by Voluntary Isocapnic Hyperpnea Versus Inspiratory Threshold Loading on Intercostales and Vastus Lateralis Muscles Deoxygenation Induced by Exercise in Physically Active Adults. BIOLOGY 2023; 12:biology12020219. [PMID: 36829497 PMCID: PMC9953077 DOI: 10.3390/biology12020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Respiratory muscle training (RMT) improves physical performance, although it is still debated whether this effect depends on the type of training. The purpose of this study was to compare the effects of two different types of RMT, i.e., voluntary isocapnic hyperpnea (VIH) and inspiratory threshold loading (ITL), on the deoxygenation of intercostal (ΔSmO2-m. intercostales) and vastus lateralis (ΔSmO2-m. vastus lateralis) muscles during exercise. Twenty-four participants performed eight weeks of RMT by: (i) VIH (3 days·week-1 for 12 min at 60% maximal voluntary ventilation) or (ii) ITL (5 sets·week-1 of 30 breaths·minute-1 at 60% maximal inspiratory pressure). Cardiopulmonary exercise testing (CPET) included ΔSmO2 (the change from baseline to end of test) of intercostal and vastus lateralis muscles. After RMT, both groups showed decreased ΔSmO2-m. intercostales (VIH = 12.8 ± 14.6%, p = 0.04 (effect size, ES = 0.59), and ITL = 8.4 ± 9.8%, p = 0.04 (ES = 0.48)), without a coincident change of ∆SmO2-m. vastus lateralis. ITL training induced higher V˙O2-peak absolute values than VIH (mean Δ post-pre, ITL = 229 ± 254 mL·min-1 [95% CI 67-391] vs. VIH, 39 ± 153 mL·min-1 [95% CI -58-136.0], p = 0.01). In conclusion, both RMT improved the balance between supply and oxygen consumption levels of m. intercostales during CPET, with ITL also inducing an increase of aerobic capacity.
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Affiliation(s)
- Maximiliano Espinosa-Ramírez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Santiago Riquelme
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Felipe Araya
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Guido Rodríguez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Fernanda Figueroa-Martínez
- Laboratory of Voice, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Luigi Gabrielli
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - W. Darlene Reid
- Department of Physical Therapy and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
- Millennium Institute for Intelligent Healthcare Engineering, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Correspondence: ; Tel.: +56-9-82288153
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Intercostal muscle oxygenation and expiratory loaded breathing at rest: Respiratory pattern effect. Respir Physiol Neurobiol 2022; 304:103925. [PMID: 35662640 DOI: 10.1016/j.resp.2022.103925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/21/2022]
Abstract
In patients with airway obstruction, an increase in breathing frequency at rest is commonly associated with a dynamic hyperinflation (DH). In such a situation, intercostal muscle oxygenation may be disturbed. This hypothesis was examined in a context of simulated airway obstruction in healthy subjects. After a control period of 5 min, twelve participants (20 ± 2 years) breathed at rest through a 20-cmH2O expiratory threshold load, either by increasing or reducing their respiratory rate (ETLF+ or ETLF). Tissue saturation index (TSI) and concentration changes in oxyhaemoglobin (oxy[Hb+Mb]) were measured as well as cardiorespiratory variables. Inspiratory capacity was decreased in ETLF+ (p < 0.001) and correlated with dyspnea. An increase in oxy[Hb+Mb] occurred in ETLF+ that was higher than in ETLF (p < 0.01). TSI was not different between conditions. In healthy subjects at rest, an increase in respiratory rate during a simulated obstruction with an expiratory threshold load resulted in paradoxical response with DH emergence while intercostal muscle oxygenation was preserved.
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Frazão M, Santos ADC, Araújo AA, Romualdo MP, de Mello BLC, Jerônimo GG, Paulino FP, Brasileiro-Santos MDS. Neuromuscular efficiency is impaired during exercise in COPD patients. Respir Physiol Neurobiol 2021; 290:103673. [PMID: 33866040 DOI: 10.1016/j.resp.2021.103673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/06/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
AIM to analyze respiratory and peripheral neuromuscular efficiency during exercise in COPD. METHODS COPD patients (VEF1 = 39.25 ± 13.1 %) were paired with healthy subjects. It was performed cardiopulmonary exercise test with simultaneously electromyography (EMG). Respiratory neuromuscular efficiency was determined by relationship between tidal volume and diaphragm EMG. Peripheral neuromuscular efficiency was determined by relationship between power output and vastus lateralis EMG. RESULTS Healthy subjects presented higher respiratory neuromuscular efficiency at moderate, heavy and maximum exercise intensities compared to COPD (p < 0.05). Healthy subjects presented higher peripheral neuromuscular efficiency at light, moderate, heavy and maximum exercise intensities compared to COPD (p < 0.001). Dynamic hyperinflation presented correlation with respiratory and peripheral neuromuscular efficiency (r = -0.73 and r = -0.76, p < 0.001). CONCLUSION COPD patients have lower respiratory neuromuscular efficiency at moderate exercise intensity and lower peripheral neuromuscular efficiency at light exercise intensity. Dynamic hyperinflation affects respiratory and peripheral neuromuscular efficiency.
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Affiliation(s)
- Murillo Frazão
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil; Associate Graduate Program in Physical Education UPE/UFPB, Brazil; CLINAR - Exercise Physiology, Brazil.
| | - Amilton da Cruz Santos
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil; Associate Graduate Program in Physical Education UPE/UFPB, Brazil
| | - Alex Andrade Araújo
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil; Associate Graduate Program in Physical Education UPE/UFPB, Brazil
| | - Michel Platini Romualdo
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Brenda Lopes Cavalcanti de Mello
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil; Associate Graduate Program in Physical Education UPE/UFPB, Brazil
| | | | | | - Maria do Socorro Brasileiro-Santos
- Laboratory of Physical Training Studies Applied to Health. Department of Physical Education, Federal University of Paraíba, João Pessoa, PB, Brazil; Associate Graduate Program in Physical Education UPE/UFPB, Brazil
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Miles M, Rodrigues A, Tajali S, Xiong Y, Orchanian-Cheff A, Reid WD, Rozenberg D. Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review. Chron Respir Dis 2021; 18:1479973121993494. [PMID: 33605155 PMCID: PMC7897842 DOI: 10.1177/1479973121993494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To synthesize evidence for prefrontal cortex (PFC), quadriceps, and respiratory muscle oxygenation using near-infrared spectroscopy (NIRS) during cycling in individuals with chronic obstructive pulmonary disease (COPD). A scoping review was performed searching databases (inception-August 2020): Ovid MEDLINE, EMBASE, Cochrane Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, CINAHL, SPORTDiscus and Pedro. The search focused on COPD, cycling, and NIRS outcomes. 29 studies (541 COPD participants) were included. Compared to healthy individuals (8 studies), COPD patients at lower cycling workloads had more rapid increases in vastus lateralis (VL) deoxygenated hemoglobin (HHb); lower increases in VL total hemoglobin (tHb) and blood flow; and lower muscle tissue saturation (StO2). Heliox and bronchodilators were associated with smaller and slower increases in VL HHb. Heliox increased VL and intercostal blood flow compared to room air and supplemental oxygen in COPD patients (1 study). PFC oxygenated hemoglobin (O2Hb) increased in COPD individuals during cycling in 5 of 8 studies. Individuals with COPD and heart failure demonstrated worse VL and PFC NIRS outcomes compared to patients with only COPD-higher or more rapid increase in VL HHb and no change or decrease in PFC O2Hb. Individuals with COPD present with a mismatch between muscle oxygen delivery and utilization, characterized by more rapid increase in VL HHb, lower muscle O2Hb and lower muscle StO2. PFC O2Hb increases or tends to increase in individuals with COPD during exercise, but this relationship warrants further investigation. NIRS can be used to identify key deoxygenation thresholds during exercise to inform PFC and muscle oxygenation.
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Affiliation(s)
- Melissa Miles
- Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Antenor Rodrigues
- Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Shirin Tajali
- Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Yijun Xiong
- Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada
| | - Ani Orchanian-Cheff
- Library and Information Services, 7989University Health Network, Toronto, Ontario, Canada
| | - W Darlene Reid
- Physical Therapy, 7938University of Toronto, Toronto, Ontario, Canada.,Interdepartmental Division of Critical Care Medicine, 7938University of Toronto, Toronto, Ontario, Canada.,KITE - Toronto Rehab-University Health Network, Toronto, Ontario, Canada
| | - Dmitry Rozenberg
- Department of Medicine, Division of Respirology, 7938University of Toronto, University Health Network, Toronto, Ontario, Canada.,Toronto General Hospital Research Institute, Toronto, Ontario, Canada
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Hardy TA, How SC, Taylor BJ. The Effect of Preexercise Expiratory Muscle Loading on Exercise Tolerance in Healthy Men. Med Sci Sports Exerc 2021; 53:421-430. [PMID: 32735113 DOI: 10.1249/mss.0000000000002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Acute nonfatiguing inspiratory muscle loading transiently increases diaphragm excitability and global inspiratory muscle strength and may improve subsequent exercise performance. We investigated the effect of acute expiratory muscle loading on expiratory muscle function and exercise tolerance in healthy men. METHODS Ten males cycled at 90% of peak power output to the limit of tolerance (TLIM) after 1) 2 × 30 expiratory efforts against a pressure-threshold load of 40% maximal expiratory gastric pressure (PgaMAX) (EML-EX) and 2) 2 × 30 expiratory efforts against a pressure-threshold load of 10% PgaMAX (SHAM-EX). Changes in expiratory muscle function were assessed by measuring the mouth pressure (PEMAX) and PgaMAX responses to maximal expulsive efforts and magnetically evoked (1 Hz) gastric twitch pressure (Pgatw). RESULTS Expiratory loading at 40% of PgaMAX increased PEMAX (10% ± 5%, P = 0.001) and PgaMAX (9% ± 5%, P = 0.004). Conversely, there was no change in PEMAX (166 ± 40 vs 165 ± 35 cm H2O, P = 1.000) or PgaMAX (196 ± 38 vs 192 ± 39 cm H2O, P = 0.215) from before to after expiratory loading at 10% of PgaMAX. Exercise time was not different in EML-EX versus SHAM-EX (7.91 ± 1.96 vs 8.09 ± 1.77 min, 95% CI = -1.02 to 0.67, P = 0.651). Similarly, exercise-induced expiratory muscle fatigue was not different in EML-EX versus SHAM-EX (-28% ± 12% vs -26% ± 7% reduction in Pgatw amplitude, P = 0.280). Perceptual ratings of dyspnea and leg discomfort were not different during EML-EX versus SHAM-EX. CONCLUSION Acute expiratory muscle loading enhances expiratory muscle function but does not improve subsequent severe-intensity exercise tolerance in healthy men.
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Affiliation(s)
- Tim A Hardy
- Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds, Leeds, UNITED KINGDOM
| | - Stephen C How
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UNITED KINGDOM
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Gonçalves TR, Soares PPDS. Positive Pressure Ventilation Improves Exercise Performance and Attenuates the Fall of Postexercise Inspiratory Muscular Strength in Rower Athletes. J Strength Cond Res 2021; 35:253-259. [PMID: 29309387 DOI: 10.1519/jsc.0000000000002420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Gonçalves, TR and Soares, PP. Positive pressure ventilation improves exercise performance and attenuates the fall of postexercise inspiratory muscular strength in rower athletes. J Strength Cond Res 35(1): 253-259, 2021-Positive pressure ventilation (PPV) can increase exercise performance in cyclists, but its effects are unclear in other exercise modes, especially those using large muscle mass. The aim of this study was to compare the exercise performance and postexercise inspiratory muscles' strength with and without PPV (NO-PPV) during rowing. Nine male rowers (19 ± 1 year) participated in 3 experimental days (M1, M2, and M3) separated by 1 week. In M1, rowers performed a 2,000-m test (2k) on a rowing ergometer to obtain average power (W2k). In M2 and M3, the rowers performed 4 minutes' workouts at 55, 65, 75, and 85% W2k, respectively, separated by 1 minute of recovery, with PPV and NO-PPV application in randomized order. Blood lactate (La) was measured during intervals. After submaximal exercises, with 10 minutes of "cool down," the rowers performed a maximal performance test of 4 minutes (4-minute all-out rowing). Traveled distance was computed and correlated with maximal inspiratory pressure (MIP) changes from pretest to posttest (∆). Positive pressure ventilation application increased the traveled distance in relation to NO-PPV exercise (1,210.7 ± 45.5 vs. 1,199.8 ± 43.4 m, p ≤ 0.05). The ∆MIP (cmH2O) was lower in PPV as compared to NO-PPV exercise (-19.1 ± 10.2 vs. -26.3 ± 7.9 cmH2O, p ≤ 0.05). The [La] showed no significant difference between PPV and NO-PPV exercises (p > 0.05). Therefore, the PPV during whole-body rowing exercise improved the exercise performance and attenuated the inspiratory postexercise fatigue. These findings suggest that inspiratory muscles' strength plays a role during high-intensity exercise with large muscle mass.
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Affiliation(s)
- Thiago R Gonçalves
- Department of Physiology and Pharmacology, Laboratory of Experimental and Applied Exercise Physiology, Fluminense Federal University, Niterói, Brazil
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Vogiatzis I, Louvaris Z, Wagner PD. Respiratory and locomotor muscle blood flow during exercise in health and chronic obstructive pulmonary disease. Exp Physiol 2020; 105:1990-1996. [PMID: 32103536 DOI: 10.1113/ep088104] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/24/2020] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the topic of this review? The work presented here focuses mostly on testing the theory of blood flow redistribution from the locomotor to the respiratory muscles during heavy exercise in healthy participants and in patients with COPD. What advances does it highlight? Studies presented and the direct experimental approach to measure muscle blood flow by indocyanine green dye detected by near infrared spectroscopy, show that exercise interferes with respiratory muscle blood flow especially in COPD, but even in healthy. ABSTRACT We have developed an indicator-dilution method to measure muscle blood flow at rest and during exercise using the light absorbing tracer indocyanine green dye (ICG) injected as an intravenous bolus, with surface optodes placed over muscles of interest to record the ICG signal by near-infrared spectroscopy. Here we review findings for both quadriceps and intercostal muscle blood flow (measured simultaneously) in trained cyclists and in patients with chronic obstructive pulmonary disease (COPD). During resting hyperpnoea in both athletes and patients, intercostal muscle blood flow increased with ventilation, correlating closely and linearly with the work of breathing, with no change in quadriceps flow. During graded exercise in athletes, intercostal flow at first increased, but then began to fall approaching peak effort. Unexpectedly, in COPD, intercostal muscle blood flow during exercise fell progressively from resting values, contrasting sharply with the response to resting hyperpnoea. During exercise at peak intensity, we found no quadriceps blood flow reduction in favour of the respiratory muscles in either athletes or patients. In COPD at peak exercise, when patients breathed 21% oxygen in helium or 100% oxygen, there was no redistribution of blood flow observed between legs and respiratory muscles in either direction. Evidence of decrease in leg blood flow and increase in respiratory muscle flow was found only when imposing expiratory flow limitation (EFL) during exercise in healthy individuals. However, because EFL caused substantial physiological derangement, lowering arterial oxygen saturation and raising end-tidal P C O 2 and heart rate, these results cannot be projected onto normal exercise.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Zafeiris Louvaris
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Rehabilitation for Internal Disorders Research Group, KU Leuven, Leuven, Belgium
| | - Peter D Wagner
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California San Diego, San Diego, CA, USA
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Bretonneau Q, Pichon A, de Bisschop C. Effect of expiratory loaded breathing during moderate exercise on intercostal muscle oxygenation. Multidiscip Respir Med 2020; 15:702. [PMID: 33154819 PMCID: PMC7610065 DOI: 10.4081/mrm.2020.702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In patients with obstructive lung disease, maintaining adequate ventilation during exercise may require greater contraction of the respiratory muscles, which may lead to a compression of muscle capillaries. Furthermore, dynamic hyperinflation (DH) is frequent during exercise in these patients, as it allows to reach higher expiratory flows and to satisfy respiratory demand. However, in such situation, intercostal muscles are likely to be stretched, which could affect the diameter of their capillaries. Thus, in a context of high level of expiratory resistance, intercostal muscle oxygenation may be disturbed during exercise, especially if DH occurs. METHODS Twelve participants (22±2 years) performed two sessions of moderate exercise (20 min) by breathing freely with and without a 20-cmH2O expiratory threshold load (ETL). Tissue saturation index (TSI) and concentration changes from rest (Δ) in oxygenated ([O2Hb]) and total haemoglobin ([tHb]) were measured in the seventh intercostal space using near-infrared spectroscopy. Respiratory, metabolic and cardiac variables were likewise recorded. RESULTS Throughout exercise, dyspnea was higher and TSI was lower in ETL condition than in control (p<0.01). After a few minutes of exercise, Δ [O2Hb] was also lower in ETL condition, as well as Δ [tHb], when inspiratory capacity started to be reduced (p<0.05). Changes in [O2Hb] and dyspnea were correlated with changes in expiratory flow rate (Vt/Te) (r = -0.66 and 0.66, respectively; p<0.05). CONCLUSION During exercise with ETL, impaired muscle oxygenation could be due to a limited increase in blood volume resulting from strong muscle contraction and/or occurrence of DH.
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Affiliation(s)
- Quentin Bretonneau
- Faculté des Sciences du Sport, Laboratoire ‘MOVE’ (EA 6314), Université de Poitiers, France
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Bretonneau Q, Pichon A, de Bisschop C. Intercostal muscle oxygenation during expiratory load breathing at rest. Respir Physiol Neurobiol 2018; 261:24-30. [PMID: 30583068 DOI: 10.1016/j.resp.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/26/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND During acute bronchial obstruction, despite a higher work of breathing, blood supply and oxygen availability may be reduced in intercostal muscles because of mechanical constraints. This hypothesis was assessed in healthy subjects breathing with and without expiratory load (ETL). METHODS Eleven men (24 ± 2 years) breathed at rest for 5 min in unloaded condition and for 20 min through a 20-cmH2O ETL. Tissue saturation index (TSI) and changes (Δ) in concentration of total and oxy-haemoglobin ([tHb] and [O2Hb]) were measured in the seventh intercostal space by near-infrared spectroscopy. RESULTS [tHb] and [O2Hb] decreased with ETL (-5.16 μM and -3.54 μM; p < 0.05). TSI did not vary. Negative correlations were observed between Δ[O2Hb] and changes in expiratory flow rate (ΔVt/Te) and between ΔTSI and Δ V˙E (r = -0.78 and -0.74; p ≤ 0.01). CONCLUSION Despite decreases in Hb concentrations, saturation in oxygen was not reduced with ETL in intercostal muscles, suggesting a satisfactory ventilatory and/or hemodynamic arrangement.
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Affiliation(s)
- Quentin Bretonneau
- Laboratoire 'MOVE', EA 6314 - Université de Poitiers, Faculté des Sciences du Sport, 8, allée Jean Monnet, 86000 Poitiers, France
| | - Aurélien Pichon
- Laboratoire 'MOVE', EA 6314 - Université de Poitiers, Faculté des Sciences du Sport, 8, allée Jean Monnet, 86000 Poitiers, France
| | - Claire de Bisschop
- Laboratoire 'MOVE', EA 6314 - Université de Poitiers, Faculté des Sciences du Sport, 8, allée Jean Monnet, 86000 Poitiers, France.
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Effects of non-fatiguing respiratory muscle loading induced by expiratory flow limitation during strenuous incremental cycle exercise on metabolic stress and circulating natural killer cells. Pflugers Arch 2017; 469:1533-1544. [DOI: 10.1007/s00424-017-2070-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/01/2017] [Accepted: 09/17/2017] [Indexed: 01/25/2023]
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Tanaka T, Basoudan N, Melo LT, Wickerson L, Brochard LJ, Goligher EC, Reid WD. Deoxygenation of inspiratory muscles during cycling, hyperpnoea and loaded breathing in health and disease: a systematic review. Clin Physiol Funct Imaging 2017; 38:554-565. [PMID: 28940670 DOI: 10.1111/cpf.12473] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
Assessing inspiratory muscle deoxygenation and blood flow can provide insight into anaerobic stress, recruitment strategies and mechanisms of inspiratory muscle limitation. Therefore, this review aimed to synthesize measurements of inspiratory muscle oxyhaemoglobin (O2 Hb), deoxyhaemoglobin (HHb), blood volume and flow of the inspiratory muscles acquired via near-infrared spectroscopy (NIRS) during cycling, hyperpnoea and loaded breathing in healthy non-athletes, healthy athletes and patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Searches were performed on Medline and Medline in-process, EMBASE, Central, Sportdiscus, PubMed and Compendex. Reviewers independently abstracted articles and assessed their quality using the modified Downs and Black checklist. Of the 644 articles identified, 21 met the inclusion criteria. Studies evaluated non-athletes (n = 9), athletes (n = 5), COPD (n = 2) and CHF (n = 5). The sample was 90% male and 73% were non-athletes and athletes. Interventions included cycle ergometry, hyperpnoea, loaded breathing, elbow flexor loading and combined loaded breathing and ergometry. Athletes and patients with CHF or COPD demonstrated deoxygenation of inspiratory accessory muscles that was often an opposite or exaggerated pattern compared to non-athletes. O2 Hb decreased and HHb increased significantly in inspiratory muscles during cycle ergometry and loaded breathing with accentuated changes during combined ergometry and loaded breathing. During different regimens of hyperpnoea or loaded breathing, comparisons of inspiratory muscles demonstrated that the sternocleidomastoid deoxygenated more than the intercostals, parasternals or scalenes. Evaluating inspiratory muscle deoxygenation via NIRS can inform mechanisms of inspiratory muscle limitation in non-athletes, athletes and patients with CHF or COPD.
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Affiliation(s)
- Takako Tanaka
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Nada Basoudan
- College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Luana T Melo
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Lisa Wickerson
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Laurent J Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Division of Respirology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Hospital Network, Toronto, ON, Canada
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Katayama K, Itoh Y, Saito M, Koike T, Ishida K. Sympathetic vasomotor outflow and blood pressure increase during exercise with expiratory resistance. Physiol Rep 2015; 3:3/5/e12421. [PMID: 26019293 PMCID: PMC4463841 DOI: 10.14814/phy2.12421] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The purpose of the present study was to elucidate the effect of increasing expiratory muscle work on sympathetic vasoconstrictor outflow and arterial blood pressure (BP) during dynamic exercise. We hypothesized that expiratory muscle fatigue would elicit increases in sympathetic vasomotor outflow and BP during submaximal exercise. The subjects performed four submaximal exercise tests; two were maximal expiratory pressure (PEmax) tests and two were muscle sympathetic nerve activity (MSNA) tests. In each test, the subjects performed two 10-min exercises at 40% peak oxygen uptake using a cycle ergometer in a semirecumbent position [spontaneous breathing for 5 min and voluntary hyperpnoea with and without expiratory resistive breathing for 5 min (breathing frequency: 60 breaths/min, inspiratory and expiratory times were set at 0.5 sec)]. PEmax was estimated before and immediately after exercises. MSNA was recorded via microneurography of the right median nerve at the elbow. PEmax decreased following exercise with expiratory resistive breathing, while no change was found without resistance. A progressive increase in MSNA burst frequency (BF) appeared during exercise with expiratory resistance (MSNA BF, without resistance: +22 ± 5%, with resistance: +44 ± 8%, P < 0.05), accompanied by an augmentation of BP (mean BP, without resistance: +5 ± 2%, with resistance: +29 ± 5%, P < 0.05). These results suggest that an enhancement of expiratory muscle activity leads to increases in sympathetic vasomotor outflow and BP during dynamic leg exercise.
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Affiliation(s)
- Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yuka Itoh
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Mitsuru Saito
- Faculty of Psychological and Physical Science, Aichigakuin University, Nisshin, Japan
| | - Teruhiko Koike
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Louvaris Z, Vogiatzis I, Aliverti A, Habazettl H, Wagner H, Wagner P, Zakynthinos S. Blood flow does not redistribute from respiratory to leg muscles during exercise breathing heliox or oxygen in COPD. J Appl Physiol (1985) 2014; 117:267-76. [PMID: 24903919 DOI: 10.1152/japplphysiol.00490.2014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In patients with chronic obstructive pulmonary disease (COPD), one of the proposed mechanisms for improving exercise tolerance, when work of breathing is experimentally reduced, is redistribution of blood flow from the respiratory to locomotor muscles. Accordingly, we investigated whether exercise capacity is improved on the basis of blood flow redistribution during exercise while subjects are breathing heliox (designed to primarily reduce the mechanical work of breathing) and during exercise with oxygen supplementation (designed to primarily enhance systemic oxygen delivery but also to reduce mechanical work of breathing). Intercostal, abdominal, and vastus lateralis muscle perfusion were simultaneously measured in 10 patients with COPD (forced expiratory volume in 1 s: 46 ± 12% predicted) by near-infrared spectroscopy using indocyanine green dye. Measurements were performed during constant-load exercise at 75% of peak capacity to exhaustion while subjects breathed room air and, then at the same workload, breathed either normoxic heliox (helium 79% and oxygen 21%) or 100% oxygen, the latter two in balanced order. Times to exhaustion while breathing heliox and oxygen did not differ (659 ± 42 s with heliox and 696 ± 48 s with 100% O2), but both exceeded that on room air (406 ± 36 s, P < 0.001). At exhaustion, intercostal and abdominal muscle blood flow during heliox (9.5 ± 0.6 and 8.0 ± 0.7 ml · min(-1)·100 g(-1), respectively) was greater compared with room air (6.8 ± 0.5 and 6.0 ± 0.5 ml·min(-1)·100 g·, respectively; P < 0.05), whereas neither intercostal nor abdominal muscle blood flow differed between oxygen and air breathing. Quadriceps muscle blood flow was also greater with heliox compared with room air (30.2 ± 4.1 vs. 25.4 ± 2.9 ml·min(-1)·100 g(-1); P < 0.01) but did not differ between air and oxygen breathing. Although our findings confirm that reducing the burden on respiration by heliox or oxygen breathing prolongs time to exhaustion (at 75% of maximal capacity) in patients with COPD, they do not support the hypothesis that redistribution of blood flow from the respiratory to locomotor muscles is the explanation.
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Affiliation(s)
- Zafeiris Louvaris
- First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece; National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece
| | - Ioannis Vogiatzis
- First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece; National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece; University of the West of Scotland, Institute of Clinical Exercise and Health Sciences, Hamilton, United Kingdom
| | - Andrea Aliverti
- Dipartimento di Biongegneria, Politecnico di Milano, Milano Italy
| | - Helmut Habazettl
- Institute of Physiology, Charite Campus Benjamin Franklin, Berlin, Germany; Institute of Anesthesiology, German Heart Institute, Berlin, Germany
| | - Harrieth Wagner
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Peter Wagner
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Spyros Zakynthinos
- First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece;
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Vogiatzis I, Zakynthinos S. Factors limiting exercise tolerance in chronic lung diseases. Compr Physiol 2013; 2:1779-817. [PMID: 23723024 DOI: 10.1002/cphy.c110015] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The major limitation to exercise performance in patients with chronic lung diseases is an issue of great importance since identifying the factors that prevent these patients from carrying out activities of daily living provides an important perspective for the choice of the appropriate therapeutic strategy. The factors that limit exercise capacity may be different in patients with different disease entities (i.e., chronic obstructive, restrictive or pulmonary vascular lung disease) or disease severity and ultimately depend on the degree of malfunction or miss coordination between the different physiological systems (i.e., respiratory, cardiovascular and peripheral muscles). This review focuses on patients with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and pulmonary vascular disease (PVD). ILD and PVD are included because there is sufficient experimental evidence for the factors that limit exercise capacity and because these disorders are representative of restrictive and pulmonary vascular disorders, respectively. A great deal of emphasis is given, however, to causes of exercise intolerance in COPD mainly because of the plethora of research findings that have been published in this area and also because exercise intolerance in COPD has been used as a model for understanding the interactions of different pathophysiologic mechanisms in exercise limitation. As exercise intolerance in COPD is recognized as being multifactorial, the impacts of the following factors on patients' exercise capacity are explored from an integrative physiological perspective: (i) imbalance between the ventilatory capacity and requirement; (ii) imbalance between energy demands and supplies to working respiratory and peripheral muscles; and (iii) peripheral muscle intrinsic dysfunction/weakness.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Greece.
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15
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Tong TK, Lin H, McConnell A, Eston R, Zheng J, Nie J. Respiratory and locomotor muscle blood-volume and oxygenation kinetics during intense intermittent exercise. Eur J Sport Sci 2012. [DOI: 10.1080/17461391.2011.566364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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16
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Limitations of respiratory muscle and vastus lateralis blood flow during continuous exercise. Respir Physiol Neurobiol 2012; 181:302-7. [DOI: 10.1016/j.resp.2012.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 04/02/2012] [Accepted: 04/03/2012] [Indexed: 11/24/2022]
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17
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Ferreira EM, Arakaki JSO, B. Barbosa P, Siqueira ACB, Bravo DM, Kapins CEB, Silva CMC, Nery LE, Alberto Neder J. Signal-morphology impedance cardiography during incremental cardiopulmonary exercise testing in pulmonary arterial hypertension. Clin Physiol Funct Imaging 2012; 32:343-52. [DOI: 10.1111/j.1475-097x.2012.01135.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 03/13/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Eloara M. Ferreira
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - Jaquelina S. Ota- Arakaki
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - Priscila B. Barbosa
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - Ana Cristina B. Siqueira
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - Daniela M. Bravo
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - Carlos Eduardo B. Kapins
- Haemodynamic Evaluation Unit; Division of Cardiology; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; Brazil
| | - Célia Maria C. Silva
- Haemodynamic Evaluation Unit; Division of Cardiology; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; Brazil
| | - Luiz Eduardo Nery
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
| | - J. Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit; Division of Respiratory Diseases; Department of Medicine; Federal University of Sao Paulo (UNIFESP); São Paulo; São Paulo; Brazil
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18
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Vogiatzis I, Andrianopoulos V, Louvaris Z, Cherouveim E, Spetsioti S, Vasilopoulou M, Athanasopoulos D. Quadriceps muscle blood flow and oxygen availability during repetitive bouts of isometric exercise in simulated sailing. J Sports Sci 2011; 29:1041-9. [PMID: 21590577 DOI: 10.1080/02640414.2011.574720] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, we wished to determine whether the observed reduction in quadriceps muscle oxygen availability, reported during repetitive bouts of isometric exercise in simulated sailing efforts (i.e. hiking), is because of restricted muscle blood flow. Six national-squad Laser sailors initially performed three successive 3-min hiking bouts followed by three successive 3-min cycling tests sustained at constant intensities reproducing the cardiac output recorded during each of the three hiking bouts. The blood flow index (BFI) was determined from assessment of the vastus lateralis using near-infrared spectroscopy in association with the light-absorbing tracer indocyanine green dye, while cardiac output was determined from impedance cardiography. At equivalent cardiac outputs (ranging from 10.3±0.5 to 14.8±0.86 L · min(-1)), the increase from baseline in vastus lateralis BFI across the three hiking bouts (from 1.1±0.2 to 3.1±0.6 nM · s(-1)) was lower (P = 0.036) than that seen during the three cycling bouts (from 1.1±0.2 to 7.2±1.4 nM · s(-1)) (Cohen's d: 3.80 nM · s(-1)), whereas the increase from baseline in deoxygenated haemoglobin (by ∼17.0±2.9 μM) (an index of tissue oxygen extraction) was greater (P = 0.006) during hiking than cycling (by ∼5.3±2.7 μM) (Cohen's d: 4.17 μM). The results suggest that reduced vastus lateralis muscle oxygen availability during hiking arises from restricted muscle blood flow in the isometrically acting quadriceps muscles.
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Affiliation(s)
- Ioannis Vogiatzis
- Faculty of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece.
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Guenette JA, Henderson WR, Dominelli PB, Querido JS, Brasher PM, Griesdale DEG, Boushel R, Sheel AW. Blood flow index using near-infrared spectroscopy and indocyanine green as a minimally invasive tool to assess respiratory muscle blood flow in humans. Am J Physiol Regul Integr Comp Physiol 2011; 300:R984-92. [DOI: 10.1152/ajpregu.00739.2010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Near-infrared spectroscopy (NIRS) in combination with indocyanine green (ICG) dye has recently been used to measure respiratory muscle blood flow (RMBF) in humans. This method is based on the Fick principle and is determined by measuring ICG in the respiratory muscles using transcutaneous NIRS in relation to the [ICG] in arterial blood as measured using photodensitometry. This method is invasive since it requires arterial cannulation, repeated blood withdrawals, and reinfusions. A less invasive alternative is to calculate a relative measure of blood flow known as the blood flow index (BFI), which is based solely on the NIRS ICG curve, thus negating the need for arterial cannulation. Accordingly, the purpose of this study was to determine whether BFI can be used to measure RMBF at rest and during voluntary isocapnic hyperpnea at 25, 40, 55, and 70% of maximal voluntary ventilation in seven healthy humans. BFI was calculated as the change in maximal [ICG] divided by the rise time of the NIRS-derived ICG curve. Intercostal and sternocleidomastoid muscle BFI were correlated with simultaneously measured work of breathing and electromyography (EMG) data from the same muscles. BFI showed strong relationships with the work of breathing and EMG for both respiratory muscles. The coefficients of determination ( R2) comparing BFI vs. the work of breathing for the intercostal and sternocleidomastoid muscles were 0.887 ( P < 0.001) and 0.863 ( P < 0.001), respectively, whereas the R2 for BFI vs. EMG for the intercostal and sternocleidomastoid muscles were 0.879 ( P < 0.001) and 0.930 ( P < 0.001), respectively. These data suggest that the BFI closely reflects RMBF in conscious humans across a wide range of ventilations and provides a less invasive and less technically demanding alternative to measuring RMBF.
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Affiliation(s)
- Jordan A. Guenette
- School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - William R. Henderson
- School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
- UBC Program of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paolo B. Dominelli
- School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan S. Querido
- School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Penelope M. Brasher
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald E. G. Griesdale
- UBC Program of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada; and
| | - Robert Boushel
- Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A. William Sheel
- School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada
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