Electrocardiogram, cardiac output, and blood lactate accumulation were recorded in three elite breath-hold divers diving to 40-55 m in a pressure chamber in thermoneutral (35 degrees C) or cool (25 degrees C) water. In two of the divers, invasive recordings of arterial blood pressure were also obtained during dives to 50 m in cool water. Bradycardia during the dives was more pronounced and developed more rapidly in the cool water, with heart rates dropping to 20-30 beats/min. Arrhythmias occurred, particularly during the dives in cool water, when they were often more frequent than sinus beats. Because of bradycardia, cardiac output decreased during the dives, especially in cool water (to <3 l/min in 2 of the divers). Arterial blood pressure increased dramatically, reaching values as high as 280/200 and 290/150 mmHg in the two divers, respectively. This hypertension was secondary to peripheral vasoconstriction, which also led to anaerobic metabolism, reflected in increased blood lactate concentration. The diving response of these divers resembles the one described for diving animals, although the presence of arrhythmias and large increases in blood pressure indicate a less perfect adaptation in humans.

Respiratory muscles can fatigue during prolonged and maximal exercise, thus reducing performance. The respiratory system is challenged during underwater exercise due to increased hydrostatic pressure and breathing resistance. The purpose of this study was to determine if two different respiratory muscle training protocols enhance respiratory function and swimming performance in divers. Thirty male subjects (23.4 +/- 4.3 years) participated. They were randomized to a placebo (PRMT), endurance (ERMT), or resistance respiratory muscle training (RRMT) protocol. Training sessions were 30 min/day, 5 days/week, for 4 weeks. PRMT consisted of 10-s breath-holds once/minute, ERMT consisted of isocapnic hyperpnea, and RRMT consisted of a vital capacity maneuver against 50 cm H(2)O resistance every 30 s. The PRMT group had no significant changes in any measured variable. Underwater and surface endurance swim time to exhaustion significantly increased after RRMT (66%, P < 0.001; 33%, P = 0.003) and ERMT (26%, P = 0.038; 38%, P < 0.001). Breathing frequency (f (b)) during the underwater endurance swim decreased in RRMT (23%, P = 0.034) and tidal volume (V (T)) increased in both the RRMT (12%, P = 0.004) and ERMT (7%, P = 0.027) groups. Respiratory endurance increased in ERMT (216.7%) and RRMT (30.7%). Maximal inspiratory and expiratory pressures increased following RRMT (12%, P = 0.015, and 15%, P = 0.011, respectively). Results from this study indicate that respiratory muscle fatigue is a limiting factor for underwater swimming performance, and that targeted respiratory muscle training (RRMT > ERMT) improves respiratory muscle and underwater swimming performance.

Physiologically acceptable limits of inspiratory impediment for air purifying respirators (APRs) were sought.Measurements on 30 subjects included pressure in, and flow through, an APR, and respiratory and cardiovascular variables. Exercise with and without APR included ladder climbing, load lift and transfer, incremental running and endurance running, with endurance at 85% peak oxygen uptake. Resistance that did not alter minute ventilation (VE) was judged acceptable long-term. Acceptable short-term impediments were deduced from end exercise conditions. Proposed long-term limits are inspiratory work of breathing per tidal volume (WOBi/VT) ≤ 0.9 kPa and peak inspiratory pressure (P (i) peak) ≤1.2 kPa. Proposed short-term limits are: for VE ≤110 L min(-1), WOBi/VT ≤1.3 kPa and P (i) peak ≤ 1.8 kPa; and for VE >130 L min(-1), WOBi/VT ≤1.6 kPa. A design relation among VE, pressure–flow coefficients of an APR, and WOBi/VT is proposed. STATEMENT OF RELEVANCE: This work generalises results from one APR by considering the altered physiological parameters related to factors inhibiting exercise. Simple expressions are proposed to connect bench-test parameters to the relation between ventilation and work of breathing. Population-based recommendations recognise that those who need more air flow can also generate higher pressures.

Dead space in breathing apparatus may cause increased ventilation and/or CO2 retention. Interactions between ventilation and dead space were tested in the breathing apparatus of three divers: a full face mask with an oro-nasal cup (AGA), a full face mask without an oro-nasal cup (EXO-26) but designed to minimize dead space, and one mouthpiece. Experiments were performed at three depths; 0, 30 and 45 m seawater (msw). The breathing gas was air except at 30 msw where it was 36 O2 in N2. Five certified SCUBA divers were exercised at three levels (0, 50 and 100 W). Ventilation and gas exchange were measured. The dead space in the AGA mask was not influenced by either depth or exercise (mean 0.201). The mean dead space of the EXO-26 was 0.341, but it increased with exercise (p < 0.001) and decreased with depth (p < 0.03). Since the dead space can vary with ventilation levels it is not sufficient to test breathing apparatus only at rest as is required by the US National Institute of Occupational Safety and Health. The mean ventilation with the EXO-26 was higher than with the AGA by 10% at 50 W (p < 0.05) and by 12% (p < 0.01) at 100 W. The same comparison for end-tidal CO2 showed mean increase by 0.30 kPa at the 100-W workload (P < 0.05); changes at other workloads were not statistically significant. Comparisons of the mean inspired PCO2 to the maximum values considered acceptable by various organizations showed that the mouthpiece was always acceptable, the AGA mask was marginally acceptable or better, while sometimes the EXO-26 was not acceptable.

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