Abstract
To determine the effects of exercise with expiratory flow-limitation (EFL) on systemic O2 delivery, seven normal subjects performed incremental exercise with and without EFL at ~0.8 l s−1 (imposed by a Starling resistor in the expiratory line) to determine maximal power output under control (W′max,c) and EFL (W′max,e) conditions. W′max,e was 62.5% of W′max,c, and EFL exercise caused a significant fall in the ventilatory threshold. In a third test, after exercising at W′max,e without EFL for 4 min, EFL was imposed; exercise continued for 4 more minutes or until exhaustion. O2 consumption \((V'_{{\text{O}}_{2}})\) was measured breath-by-breath for the last 90 s of control, and for the first 90 s of EFL exercise. Assuming that the arterio-mixed venous O2 content remained constant immediately after EFL imposition, we used \(V'_{{\text{O}}_{2}} \) as a measure of cardiac output (Q′c). Q′c was also calculated by the pulse contour method with blood pressure measured continuously by a photo-plethysmographic device. Both sets of data showed a decrease of Q′c due to a decrease in stroke volume by 10% \((p<0.001\;\hbox{for}\;V'_{{\text{O}}_{2}})\) with EFL and remained decreased for the full 90 s. Concurrently, arterial O2 saturation decreased by 5%, abdominal, pleural and alveolar pressures increased, and duty cycle decreased by 43%. We conclude that this combination of events led to a decrease in venous return secondary to high expiratory pressures, and a decreased duty cycle which decreased O2 delivery to working muscles by ~15%.
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The authors acknowledge Dr. Enrico Tam for his help in calculating stroke volume by using the Modelflow model based on the pulse contour method.
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Aliverti, A., Dellacà, R.L., Lotti, P. et al. Influence of expiratory flow-limitation during exercise on systemic oxygen delivery in humans. Eur J Appl Physiol 95, 229–242 (2005). https://doi.org/10.1007/s00421-005-1386-4
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DOI: https://doi.org/10.1007/s00421-005-1386-4