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Cross TJ, Isautier JMJ, Kelley EF, Hubbard CD, Morris SJ, Smith JR, Duke JW. A Systematic Review of Methods Used to Determine the Work of Breathing during Exercise. Med Sci Sports Exerc 2023; 55:1672-1682. [PMID: 37126027 DOI: 10.1249/mss.0000000000003187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Measurement of the work of breathing (Wb) during exercise provides useful insights into the energetics and mechanics of the respiratory muscles across a wide range of minute ventilations. The methods and analytical procedures used to calculate the Wb during exercise have yet to be critically appraised in the literature. PURPOSE The aim of this systematic review was to evaluate the quality of methods used to measure the Wb during exercise in the available literature. METHODS We conducted an extensive search of three databases for studies that measured the Wb during exercise in adult humans. Data were extracted on participant characteristics, flow/volume and pressure devices, esophageal pressure (P oes ) catheters, and methods of Wb analysis. RESULTS A total of 120 articles were included. Flow/volume sensors used were primarily pneumotachographs ( n = 85, 70.8%), whereas the most common pressure transducer was of the variable reluctance type ( n = 63, 52.5%). Esophageal pressure was frequently obtained via balloon-tipped catheters ( n = 114, 95.0%). Few studies mentioned calibration, frequency responses, and dynamic compensation of their measurement devices. The most popular method of measuring the Wb was pressure-volume integration ( n = 51, 42.5%), followed by the modified Campbell ( n = 28, 23.3%) and Dean & Visscher diagrams ( n = 26, 21.7%). Over one-third of studies did not report the methods used to process their pressure-volume data, and the majority (60.8%) of studies used the incorrect Wb units and/or failed to discuss the limitations of their Wb measurements. CONCLUSIONS The findings of this systematic review highlight the need for the development of a standardized approach for measuring Wb, which is informative, practical, and accessible for future researchers.
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Affiliation(s)
- Troy J Cross
- Faculty of Medicine and Health, University of Sydney, NSW, AUSTRALIA
| | | | - Eli F Kelley
- Air Force Research Laboratory, 711HPW/RHBFP, Wright-Patterson Air Force Base, OH
| | - Colin D Hubbard
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
| | - Sarah J Morris
- Faculty of Medicine and Health, University of Sydney, NSW, AUSTRALIA
| | - Joshua R Smith
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
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do Nascimento Salvador PC, Nascimento EMF, Antunes D, Guglielmo LGA, Denadai BS. Energy metabolism and muscle activation heterogeneity explain V ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ slow component and muscle fatigue of cycling at different intensities. Exp Physiol 2023; 108:503-517. [PMID: 36648072 PMCID: PMC10103881 DOI: 10.1113/ep090444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023]
Abstract
NEW FINDINGS What is the central question of this study? What are the physiological mechanisms underlying muscle fatigue and the increase in the O2 cost per unit of work during high-intensity exercise? What is the main finding and its importance? Muscle fatigue happens before, and does not explain, theV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ slow component (V ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ ), but they share the same origin. Muscle activation heterogeneity is associated with muscle fatigue andV ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ . Knowing this may improve training prescriptions for healthy people leading to improved public health outcomes. ABSTRACT This study aimed to explain theV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ slow component (V ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ ) and muscle fatigue during cycling at different intensities. The muscle fatigue of 16 participants was determined through maximal isokinetic effort lasting 3 s during constant work rate bouts of moderate (MOD), heavy (HVY) and very heavy intensity (VHI) exercise. Breath-by-breathV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ , near-infrared spectroscopy signals and EMG activity were analysed (thigh muscles).V ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ was higher during VHI exercise (∼70% vs. ∼28% ofV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ reserve in HVY). The deoxygenated haemoglobin final value during VHI exercise was higher than during HVY and MOD exercise (∼90% of HHb physiological normalization, vs. ∼82% HVY and ∼45% MOD). The muscle fatigue was greater after VHI exercise (∼22% vs. HVY ∼5%). There was no muscle fatigue after MOD exercise. The greatest magnitude of muscle fatigue occurred within 2 min (VHI ∼17%; HVY ∼9%), after which it stabilized. No significant relationship betweenV ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ and muscle force production was observed. The τ of muscleV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ was significantly related (R2 = 0.47) with torque decrease for VHI. Type I and II muscle fibre recruitment mainly in the rectus femoris moderately explained the muscle fatigue (R2 = 0.30 and 0.31, respectively) and theV ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ (R2 = 0.39 and 0.27, respectively). TheV ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ is also partially explained by blood lactate accumulation (R2 = 0.42). In conclusion muscle fatigue and O2 cost seem to share the same physiological cause linked with a decrease in the muscleV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ and a change in lactate accumulation. Muscle fatigue andV ̇ O 2 sc ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{sc}}}$ are associated with muscle activation heterogeneity and metabolism of different muscles activated during cycling.
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Affiliation(s)
- Paulo Cesar do Nascimento Salvador
- Physical effort LaboratorySports CentreFederal University of Santa CatarinaFlorianopolisBrazil
- Leonardo da Vinci University – Uniasselvi/VITRU EducationIndaialBrazil
| | | | - Diego Antunes
- Physical effort LaboratorySports CentreFederal University of Santa CatarinaFlorianopolisBrazil
| | | | - Benedito Sérgio Denadai
- Physical effort LaboratorySports CentreFederal University of Santa CatarinaFlorianopolisBrazil
- Human Performance LaboratorySão Paulo State UniversityRio ClaroBrazil
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Cross TJ, Gideon EA, Morris SJ, Coriell CL, Hubbard CD, Duke JW. A comparison of methods used to quantify the work of breathing during exercise. J Appl Physiol (1985) 2021; 131:1123-1133. [PMID: 34410846 DOI: 10.1152/japplphysiol.00411.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The mechanical work of breathing (Wb) is an insightful tool used to assess respiratory mechanics during exercise. There are several different methods used to calculate the Wb, however, each approach having its own distinct advantages/disadvantages. To date, a comprehensive assessment of the differences in the components of Wb between these methods is lacking. We therefore sought to compare the values of Wb during graded exercise as determined via the four most popular methods: 1) pressure-volume integration; 2) the Hedstrand diagram; 3) the Otis diagram; and the 4) modified Campbell diagram. Forty-two participants (30 ± 15 yr; 16 women) performed graded cycling to volitional exhaustion. Esophageal pressure-volume loops were obtained throughout exercise. These data were used to calculate the total Wb and, where possible, its subcomponents of inspiratory and expiratory, resistive and elastic Wb, using each of the four methods. Our results demonstrate that the components of Wb were indeed different between methods across the minute ventilations engendered by graded exercise. Importantly, however, no systematic pattern in these differences could be observed. Our findings indicate that the values of Wb obtained during exercise are uniquely determined by the specific method chosen to compute its value-no two methods yield identical results. Because there is currently no "gold-standard" for measuring the Wb, it is emphasized that future investigators be cognizant of the limitations incurred by their chosen method, such that observations made by others may be interpreted with greater context, and transparency.NEW & NOTEWORTHY The measurement of the work of breathing (Wb) during exercise provides us with deep insights into respiratory (patho)physiology, and sheds light on the putative factors which lead to respiratory muscle fatigue. There are 4 popular methods available to determine the Wb. Our study demonstrates that no two of these methods produce identical values of Wb during exercise. This paper also discusses the practical and theoretical limitations of each method.
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Affiliation(s)
- Troy J Cross
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Elizabeth A Gideon
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Sarah J Morris
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Catherine L Coriell
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Colin D Hubbard
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
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Gideon EA, Cross TJ, Coriell CL, Duke JW. The effect of estimating chest wall compliance on the work of breathing during exercise as determined via the modified Campbell diagram. Am J Physiol Regul Integr Comp Physiol 2021; 320:R268-R275. [PMID: 33356877 DOI: 10.1152/ajpregu.00263.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The modified Campbell diagram provides one of the most comprehensive assessments of the work of breathing (Wb) during exercise, wherein the resistive and elastic work of inspiration and expiration are quantified. Importantly, a necessary step in constructing the modified Campbell diagram is to obtain a value for chest wall compliance (CCW). To date, it remains unknown whether estimating or directly measuring CCW impacts the Wb, as determined by the modified Campbell diagram. Therefore, the purpose of this study was to evaluate whether the components of the Wb differ when the modified Campbell diagram is constructed using an estimated versus measured value of CCW. Forty-two participants (n = 26 men, 16 women) performed graded exercise to volitional exhaustion on a cycle ergometer. CCW was measured directly at rest via quasistatic relaxation. Estimated values of CCW were taken from prior literature. The measured value of CCW was greater than that obtained via estimation (214 ± 52 mL/cmH2O vs. 189 ± 18 mL/cmH2O; P < 0.05). At modest-to-high minute ventilations (i.e., 50-200 L/min), the inspiratory elastic Wb was greater and expiratory resistive Wb was lower, when modified Campbell diagrams were constructed using estimated compared with measured values of CCW (P = 0.001). These differences were however small and never exceeded ±5%. Thus, although our findings demonstrate that estimating CCW has a measurable impact on the determination of the Wb, its effect appears relatively small within a cohort of healthy adults during graded exercise.
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Affiliation(s)
- Elizbeth A Gideon
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Troy J Cross
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Catherine L Coriell
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
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Gideon EA, Cross TJ, Cayo BE, Betts AW, Merrell DS, Coriell CL, Hays LE, Duke JW. Thoracic gas compression during forced expiration is greater in men than women. Physiol Rep 2020; 8:e14404. [PMID: 32207254 PMCID: PMC7090372 DOI: 10.14814/phy2.14404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/29/2020] [Indexed: 11/24/2022] Open
Abstract
Intrapleural pressure during a forced vital capacity (VC) maneuver is often in excess of that required to generate maximal expiratory airflow. This excess pressure compresses alveolar gas (i.e., thoracic gas compression [TGC]), resulting in underestimated forced expiratory flows (FEFs) at a given lung volume. It is unknown if TGC is influenced by sex; however, because men have larger lungs and stronger respiratory muscles, we hypothesized that men would have greater TGC. We examined TGC across the "effort-dependent" region of VC in healthy young men (n = 11) and women (n = 12). Subjects performed VC maneuvers at varying efforts while airflow, volume, and esophageal pressure (POES ) were measured. Quasistatic expiratory deflation curves were used to obtain lung recoil (PLUNG ) and alveolar pressures (i.e., PALV = POES -PLUNG ). The raw maximal expiratory flow-volume (MEFVraw ) curve was obtained from the "maximum effort" VC maneuver. The TGC-corrected curve was obtained by constructing a "maximal perimeter" curve from all VC efforts (MEFVcorr ). TGC was examined via differences between curves in FEFs (∆FEF), area under the expiratory curves (∆AEX ), and estimated compressed gas volume (∆VGC) across the VC range. Men displayed greater total ∆AEX (5.4 ± 2.0 vs. 2.0 ± 1.5 L2 ·s-1 ; p < .001). ∆FEF was greater in men at 25% of exhaled volume only (p < .05), whereas ∆VGC was systematically greater in men across the entire VC (main effect; p < .05). PALV was also greater in men throughout forced expiration (p < .01). Taken together, these findings demonstrate that men display more TGC, occurring early in forced expiration, likely due to greater expiratory pressures throughout the forced VC maneuver.
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Affiliation(s)
- Elizabeth A Gideon
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Troy J Cross
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
- Griffith University, Menzies Health Institute Queensland, Brisbane, QLD, Australia
| | - Brooke E Cayo
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Aaron W Betts
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Dallin S Merrell
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Catherine L Coriell
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Lauren E Hays
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
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Welch JF, Kipp S, Sheel AW. Respiratory muscles during exercise: mechanics, energetics, and fatigue. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Chéhère B, Bougault V, Gicquello A, Wallaert B. Cardiorespiratory Response to Different Exercise Tests in Interstitial Lung Disease. Med Sci Sports Exerc 2017; 48:2345-2352. [PMID: 27434081 DOI: 10.1249/mss.0000000000001051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The 6-min stepper test (6MST) has been used as an alternative to the 6-min walk test (6MWT) to assess exercise tolerance in patients with interstitial lung disease (ILD). Recent data suggest that the tests may involve different energy pathways and cardiorespiratory responses. We thus aimed to compare the cardiorespiratory responses of ILD patients during the 6MWT and the 6MST. METHODS Thirty-one patients with ILD were randomized to perform both tests in the order 6MST → 6MWT (n = 16) or 6MWT → 6MST (n = 15). Gas exchange, HR, and pulse O2 saturation (SpO2) were measured continuously, and dyspnoea, leg discomfort, and blood lactate concentration were assessed before and immediately after each test. RESULTS Oxygen uptake (V˙O2) was lower (P = 0.002) and respiratory equivalent ratio for O2 (V˙E/V˙O2) and RER were higher (both P < 0.001) during the 6MST compared with the 6MWT. The 6MST was also associated with higher blood lactate concentrations (6MST, 4.16 ± 1.95 mmol·L; 6MWT, 2.84 ± 1.17 mmol·L; P = 0.01), higher leg discomfort scores (6MST 5 ± 3 points, 6MWT 3 ± 2 points; P < 0.001), and smaller decreases in SpO2 (6MST -5% ± 5%, 6MWT -9% ± 6%; P < 0.001). CONCLUSIONS ILD patients exhibited greater ventilatory responses and lower arterial O2 desaturation during the 6MST compared with the 6MWT. The higher lactate concentrations and perceived muscle fatigue observed during the 6MST may indicate the presence of intertest differences in active muscle metabolism that could contribute to the distinct cardiorespiratory responses.
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Affiliation(s)
- Baptiste Chéhère
- 1Univ. Lille, EA 7369-URePSSS-Multidisciplinary Research Unit in Sport Health Society, Lille, FRANCE; and 2Service of Pneumology and Immuno-Allergology, Competence Centre for Rare Lung Diseases, Calmette Hospital, Lille, FRANCE
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8
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Oueslati F, Boone J, Tabka Z, Ahmaidi S. Respiratory and locomotor muscle implications on the VO 2 slow component and the VO 2 excess in young trained cyclists. Respir Physiol Neurobiol 2017; 239:1-9. [PMID: 28159632 DOI: 10.1016/j.resp.2017.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/10/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
We investigated the impact of ramp and constant-load exercise on (i) respiratory muscle fatigue and locomotor muscle oxygenation, (ii) their relationship with the excess VO2 and VO2 slow component (SC). Fourteen male cyclists performed two tests to exhaustion: an incremental ramp and a constant-load exercise with continuous monitoring of expired gases and oxygenation of the vastus lateralis muscle on two separate days. Maximal inspiratory (MIP) and expiratory (MEP) pressure measurements were taken at rest and post- exercise. The VO2 excess represents the difference between VO2max observed and VO2max expected using linear equation between the VO2 and the intensity before gas-exchange threshold. During the ramp exercise, MIP and MEP declined by 13±8 and 19±10%, respectively (p<0.05). MIP and MEP were not correlated to the excess VO2 (0.09±0.05lmin-1). During the constant-load exercise, the VO2 SC (0.70±0.22lmin-1) was correlated (r=0.68, p<0.01) to deoxyhemoglobin SC (2.94±1.25AU) but not to the excess VO2 (r=0.30, p=0.2). Additionally, the significant decrease in MIP (20±9%) and MEP (23±11%) was correlated (r=0.55, p<0.05 and r=0.75, p<0.05, respectively) to the VO2 SC. Our results show that respiratory muscle fatigue was correlated to the VO2 SC in the constant-load exercise, whereas it was not correlated to the excess VO2 in ramp exercise may be because of our small excess VO2.
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Affiliation(s)
- Ferid Oueslati
- EA-3300: APERE, Sport Sciences Department, University of Picardie Jules Verne, Amiens, France; UR12ES06, Medicine Department, University of Sousse, Sousse, Tunisie; Faculty of Sciences, University of Carthage, Bizerte, Tunisie.
| | - Jan Boone
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Zouhair Tabka
- UR12ES06, Medicine Department, University of Sousse, Sousse, Tunisie
| | - Said Ahmaidi
- EA-3300: APERE, Sport Sciences Department, University of Picardie Jules Verne, Amiens, France
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Boone J, Vandekerckhove K, Coomans I, Prieur F, Bourgois JG. An integrated view on the oxygenation responses to incremental exercise at the brain, the locomotor and respiratory muscles. Eur J Appl Physiol 2016; 116:2085-2102. [PMID: 27613650 DOI: 10.1007/s00421-016-3468-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/31/2016] [Indexed: 12/26/2022]
Abstract
In the past two decades oxygenation responses to incremental ramp exercise, measured non-invasively by means of near-infrared spectroscopy at different locations in the body, have advanced the insights on the underpinning mechanisms of the whole-body pulmonary oxygen uptake ([Formula: see text]) response. In healthy subjects the complex oxygenation responses at the level of locomotor and respiratory muscles, and brain were simplified and quantified by the detection of breakpoints as a deviation in the ongoing response pattern as work rate increases. These breakpoints were located in a narrow intensity range between 75 and 90 % of the maximal [Formula: see text] and were closely related to traditionally determined thresholds in pulmonary gas exchange (respiratory compensation point), blood lactate measurements (maximal lactate steady state), and critical power. Therefore, it has been assumed that these breakpoints in the oxygenation patterns at different sites in the body might be equivalent and could, therefore, be used interchangeably. In the present review the typical oxygenation responses (at locomotor and respiratory muscle level, and cerebral level) are described and a possible framework is provided showing the physiological events that might link the breakpoints at different body sites with the thresholds determined from pulmonary gas exchange and blood lactate measurements. However, despite a possible physiological association, several arguments prevent the current practical application of these breakpoints measured at a single site as markers of exercise intensity making it highly questionable whether measurements of the oxygenation response at one single site can be used as a reflection of whole-body responses to different exercise intensities.
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Affiliation(s)
- Jan Boone
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
- Center of Sports Medicine, Ghent University Hospital, Ghent, Belgium.
| | | | - Ilse Coomans
- Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium
| | - Fabrice Prieur
- CIAMS, Univ Paris-Sud, Université Paris Saclay, 91405, Orsay Cedex, France
- CIAMS Université d'Orléans, 45067, Orléans, France
| | - Jan G Bourgois
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Center of Sports Medicine, Ghent University Hospital, Ghent, Belgium
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Cross TJ, Beck KC, Johnson BD. Correcting the dynamic response of a commercial esophageal balloon-catheter. J Appl Physiol (1985) 2016; 121:503-11. [PMID: 27402558 DOI: 10.1152/japplphysiol.00155.2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/03/2016] [Indexed: 11/22/2022] Open
Abstract
It is generally recommended that an esophageal balloon-catheter possess an adequate frequency response up to 15 Hz, such that parameters of respiratory mechanics may be quantified with precision. In our experience, however, we have observed that some commercially available systems do not display an ideal frequency response (<8-10 Hz). We therefore investigated whether the poor frequency response of a commercially available esophageal catheter may be adequately compensated using two numerical techniques: 1) an exponential model correction, and 2) Wiener deconvolution. These two numerical techniques were performed on a commercial balloon-catheter interfaced with 0, 1, and 2 lengths of extension tubing (90 cm each), referred to as configurations L0, L90, and L180, respectively. The frequency response of the balloon-catheter in these configurations was assessed by empirical transfer function analysis, and its "working" range was defined as the frequency beyond which more than 5% amplitude and/or phase distortion was observed. The working frequency range of the uncorrected balloon-catheter extended up to only 10 Hz for L0, and progressively worsened with additional tubing length (L90 = 3 Hz, L180 = 2 Hz). Although both numerical methods of correction adequately enhanced the working frequency range of the balloon-catheter to beyond 25 Hz for all length configurations (L0, L90, and L180), Wiener deconvolution consistently provided more accurate corrections. Our data indicate that Wiener deconvolution provides a superior correction of the balloon-catheter's dynamic response, and is relatively more robust to extensions in catheter tube length compared with the exponential correction method.
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Affiliation(s)
- Troy J Cross
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; and Menzie Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Kenneth C Beck
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; and
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; and
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Cross TJ, Lalande S, Hyatt RE, Johnson BD. Response characteristics of esophageal balloon catheters handmade using latex and nonlatex materials. Physiol Rep 2015; 3:3/6/e12426. [PMID: 26077619 PMCID: PMC4510628 DOI: 10.14814/phy2.12426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The measurement of esophageal pressure allows for the calculation of several important and clinically useful parameters of respiratory mechanics. Esophageal pressure is often measured with balloon-tipped catheters. These catheters may be handmade from natural latex condoms and polyethylene tubing. Given the potential of natural latex to cause allergic reaction, it is important to determine whether esophageal catheter balloons can be fabricated, by hand, using nonlatex condoms as construction materials. To determine the static and dynamic response characteristics of esophageal balloon catheters handmade from latex and nonlatex materials, six esophageal catheter balloons were constructed from each of the following condom materials: natural latex, synthetic polyisoprene, and polyurethane (18 total). Static compliance and working volume range of each balloon catheter was obtained from their pressure-volume characteristics in water. The dynamic response of balloon catheters were measured via a pressure “step” test, from which a third-order underdamped transfer function was modeled. The dynamic ranges of balloon catheters were characterized by the frequencies corresponding to ±5% amplitude- and phase-distortion (fA5% and fφ5%). Balloon catheters handmade from polyurethane condoms displayed the smallest working volume range and lowest static balloon compliance. Despite this lower compliance, fA5% and fφ5% were remarkably similar between all balloon materials. Our findings suggest that polyisoprene condoms are an ideal nonlatex construction material to use when fabricating esophageal catheter balloons by hand.
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Affiliation(s)
- Troy J Cross
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Sophie Lalande
- Department of Kinesiology, University of Toledo, Toledo, Ohio
| | - Robert E Hyatt
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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