Exercise-induced interstitial pulmonary edema at sea-level in young and old healthy humans

Taylor, Bryan J.; Carlson, Alex R.; Miller, Andrew D.; Johnson, Bruce D.

doi:10.1016/j.resp.2013.10.012

Cited by 18 publications

(22 citation statements)

References 46 publications

(88 reference statements)

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“…The D M,CO values calculated via the multiple-FiO 2 method in the present study (Table 4) are similar to those previously reported (Ceridon et al., 2010; de Bisschop et al, 2012; Snyder et al, 2008; Taylor et al, 2014). However, the V C values found presently are similar to some (de Bisschop et al, 2012) but somewhat greater than other (Ceridon et al, 2010; Snyder et al, 2008; Taylor et al, 2014) previously reported data.…”

Section: Discussionsupporting

confidence: 92%

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Optimizing the calculation of D M,CO and V C via the single breath single oxygen tension DL CO/NO method

Coffman

Taylor

Carlson

et al. 2016

Respiratory Physiology & Neurobiology

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Alveolar-capillary membrane conductance (DM,CO) and pulmonary-capillary blood volume (VC) are calculated via lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO) using the single breath, single oxygen tension (single-FiO2) method. However, two calculation parameters, the reaction rate of carbon monoxide with blood (θCO) and the DM,NO/DM,CO ratio (α-ratio), are controversial. This study systematically determined optimal θCO and α-ratio values to be used in the single-FiO2 method that yielded the most similar DM,CO and VC values compared to the ‘gold-standard’ multiple-FiO2 method. Eleven healthy subjects performed single breath DLCO/DLNO maneuvers at rest and during exercise. DM,CO and VC were calculated via the single-FiO2 and multiple-FiO2 methods by implementing seven θCO equations and a range of previously reported α-ratios. The RP θCO equation (Reeves and Park, Respiration physiology 88:1–21, 1992.) and an α-ratio of 4.0–4.4 yielded DM,CO and VC values that were most similar between methods. The RP θCO equation and an experimental α-ratio should be used in future studies.

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Section: Discussionsupporting

confidence: 92%

“…D M,CO values were significantly increased with exercise for all θ CO equations, while V C values were not significantly increased for any equation (Table 4). All equations yielded similar values to other studies for D M,CO and V C (Ceridon et al, 2010; de Bisschop et al., 2012; Snyder et al, 2008; Taylor et al, 2014). …”

Section: Resultssupporting

confidence: 81%

Optimizing the calculation of D M,CO and V C via the single breath single oxygen tension DL CO/NO method

Coffman

Taylor

Carlson

et al. 2016

Respiratory Physiology & Neurobiology

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“…In healthy humans, exercise is associated with an increase in cardiac output and pulmonary perfusion pressure that causes both recruitment of under-perfused pulmonary capillaries and distension of already perfused pulmonary blood vessels, as evidenced by an increase in DLCO, Dm CO , and V C (La Gerche et al, 2010; Tamhane et al, 2001; Taylor et al, 2014). Therefore, it is crucial that measures of Dm CO and Vc increase accordingly in response to exercise, regardless of whether θ NO is assumed to be infinite or finite.…”

Section: Resultsmentioning

confidence: 99%

The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

Coffman¹,

Chase²,

Taylor

et al. 2017

Respiratory Physiology & Neurobiology

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Whether the specific blood transfer conductance for nitric oxide (NO) with hemoglobin (θNO) is finite or infinite is controversial but important in the calculation of alveolar capillary membrane conductance (DmCO) and pulmonary capillary blood volume (VC) from values of lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO). In this review, we discuss the background associated with θNO, explore the resulting values of DmCO and VC when applying either assumption, and investigate the mathematical underpinnings of DmCO and VC calculations. In general, both assumptions yield reasonable rest and exercise DmCO and VC values. However, the finite θNO assumption demonstrates increasing VC, but not DmCO, with submaximal exercise. At relatively high, but physiologic, DLNO/DLCO ratios both assumptions can result in asymptotic behavior for VC values, and under the finite θNO assumption, DmCO values. In conclusion, we feel that the assumptions associated with a finite θNO require further in vivo validation against an established method before widespread research and clinical use.

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“…Individual contribution of each of these factors varies depending on the exposure. While clear evidence of cardiac and pulmonary abnormalities have not been found [82], individual variation in susceptibility [8,83] due either to variations in capillary strength, left ventricular relaxation, pulmonary vascular reactivity under conditions of exercise, and the instantaneous state of blood and fluid volume are likely to contribute to the development of pulmonary oedema.…”

Section: Discussionmentioning

confidence: 98%

Lung injury related to extreme environments

Adir

Bové

2014

Eur Respir Rev

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@ERSpublications Lung injury is a well understood and preventable consequence of water immersion while swimming and diving http://ow.ly/AOdvgAs extreme sports become more popular, related respiratory injury may compromise the athlete's performance and result in morbidity and even mortality. In this article we will discuss different lung injuries in relation to performing different activities in an extreme environment. Hydrostatic lung injuriesThe evolution of fish to amphibians, reptiles to endothermic birds and mammals has been accompanied by a progressively thinner pulmonary blood gas barrier, to accommodate the constraint of increased oxygen uptake and carbon dioxide output [1]. Accordingly, pulmonary circulation has evolved as a separate high flow-low pressure system. In humans, mean pulmonary artery pressures (PAP) are 8-20 mmHg, pulmonary wedge pressures are 5-14 mmHg and pulmonary capillary pressures are 8-12 mmHg [2]. A low-pressure regimen preserves the integrity of an alveolar capillary membrane only 0.3 mm thick. However, this structure is vulnerable to increased pressures during strenuous exercise or environmental hypoxic exposure as a cause of stress failure of the pulmonary capillaries and accumulation of extravascular lung water [3]. Reports of lung injury related to extremes of exercise and variations in ambient pressure and altitude confirm this vulnerability. The resulting lung injury takes the form of noncardiogenic pulmonary oedema.The occurrence of noncardiogenic pulmonary oedema and pulmonary haemorrhage has been described in relation to a variety of disorders related to auto-and exogenous immunological reactions, infections and certain inhalants. However, numerous reports of lung injury manifesting as pulmonary oedema with associated haemorrhage have been described more recently in relation to immersion underwater, swimming, extreme exercise and exposure to altitude. In addition, pulmonary oedema resulting from negative intra-alveolar pressure has been described in the anaesthesia literature and may play a role in exercise-and immersion-induced pulmonary oedema. Haemodynamically induced pulmonary oedemaA single mechanism responsible for production of noncardiogenic pulmonary oedema related to immersion, altitude and exercise has not been identified. However, a combination of haemodynamically related factors, alterations in capillary integrity, increased blood volume and increased cardiac output may all contribute to the syndrome. WEST et al.[4] described exercise-induced pulmonary haemorrhage in race For editorial comments see page 401.

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Exercise-induced interstitial pulmonary edema at sea-level in young and old healthy humans

Cited by 18 publications

References 46 publications

Optimizing the calculation of D M,CO and V C via the single breath single oxygen tension DL CO/NO method

Optimizing the calculation of D M,CO and V C via the single breath single oxygen tension DL CO/NO method

The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

Lung injury related to extreme environments

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