Inter-individual differences in control of alveolar capillary blood volume in exercise and hypoxia

Bartesaghi, Manuela; Beretta, Egidio; Pollastri, Luca; Scotti, Valentina Rita; Mandolesi, Gaia; Lanfranconi, Francesca; Miserocchi, Giuseppe

doi:10.1016/j.resp.2013.08.021

Cited by 17 publications

(17 citation statements)

References 29 publications

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“…Similarly, although a reduction in SpO 2 has been thought to be related pulmonary O 2 diffusion capacity 1,2 , a previous study found greater inter-individual differences in the alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume, which are subcomponents of total lung diffusion capacity with an inspiration of different concentration of O 2 (20-40-60% O 2 ) 35 . Similar results (i.e., greater inter-indvidual differences in lung diffusion capacity) were found under hypobaric hypoxia at rest 36 and during sub-maximal exercise 37 . In light of these previous studies, it is evident that lung diffusion capacity (which may affect SpO 2 ) causes inter-individual differences under different barometric pressure condition and/or fraction of inspired oxygen.…”

Section: Discussionsupporting

confidence: 77%

Sex differences in respiratory and circulatory cost during hypoxic walking: potential impact on oxygen saturation

Horiuchi

Kirihara

Fukuoka

et al. 2019

Sci Rep

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Energy expenditure (EE) during treadmill walking under normal conditions (normobaric normoxia, 21% O 2 ) and moderate hypoxia (13% O 2 ) was measured. Ten healthy young men and ten healthy young women walked on a level (0°) gradient a range of speeds (0.67–1.67 m s −1 ). During walking, there were no significant differences in reductions in arterial oxygen saturation (SpO 2 ) between the sexes. The hypoxia-induced increase in EE, heart rate (HR [bpm]) and ventilation ( [L min −1 ]) were calculated. Using a multivariate model that combined EE, , and HR to predict ΔSpO 2 (hypoxia-induced reduction), a very strong fit model both for men (r 2 = 0.900, P < 0.001) and for women was obtained (r 2 = 0.957, P < 0.001). The contributions of EE, VE, and HR to ΔSpO 2 were markedly different between men and women. and EE had a stronger effect on ΔSpO 2 in women ( : 4.1% in women vs. 1.7% in men; EE: 28.1% in women vs. 15.8% in men), while HR had a greater effect in men (82.5% in men and 67.9% in women). These findings suggested that high-altitude adaptation in response to hypoxemia has different underlying mechanisms between men and women. These results can help to explain how to adapt high-altitude for men and women, respectively.

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Section: Discussionsupporting

confidence: 77%

Sex differences in respiratory and circulatory cost during hypoxic walking: potential impact on oxygen saturation

Horiuchi

Kirihara

Fukuoka

et al. 2019

Sci Rep

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“…The importance of this point becomes relevant when balanced against an increase in cells metabolic requirement, namely the increased oxygen demand, as in exercise, as well as in conditions causing a limitation to oxygen delivery (environmental hypoxia and cardio-pulmonary disorders). Recent work from our group revealed considerable inter-individual differences in the adaptive response of the air-blood barrier to work in normoxia and hypoxia 1–3 and further the adaptations correlated with the morpho-functional phenotype of the air-blood barrier 4 .…”

Section: Introductionmentioning

confidence: 71%

“…At sea level (SL) an incremental exercise test was performed on a cycloergometer 1 (Ergoline 900, Cosmed, Italy). After 2 min of unloading pedaling, the workload was increased every 60 s until voluntary exhaustion.…”

Section: Methodsmentioning

confidence: 99%

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Differences in alveolo-capillary equilibration in healthy subjects on facing O2 demand

Beretta

Grasso

Forcaia

et al. 2019

Sci Rep

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Oxygen diffusion across the air-blood barrier in the lung is commensurate with metabolic needs and ideally allows full equilibration between alveolar and blood partial oxygen pressures. We estimated the alveolo-capillary O2 equilibration in 18 healthy subjects at sea level at rest and after exposure to increased O2 demand, including work at sea level and on hypobaric hypoxia exposure at 3840 m (PA ~ 50 mmHg). For each subject we estimated O2 diffusion capacity (DO2), pulmonary capillary blood volume (Vc) and cardiac output (). We derived blood capillary transit time and the time constant of the equilibration process (, β being the slope of the hemoglobin dissociation curve). O2 equilibration at the arterial end of the pulmonary capillary was defined as . Leq greately differed among subjects in the most demanding O2 condition (work in hypoxia): lack of full equilibration was found to range from 5 to 42% of the alveolo-capillary PO2 gradient at the venous end. The present analysis proves to be sensible enough to highlight inter-individual differences in alveolo-capillary equilibration among healthy subjects.

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“…This mechanism can be affected by increased blood volume, reduced left ventricular compliance and reduced myocardial function. BARTESAGHI et al [7] suggested that a ratio of capillary volume to alveolar volume that increases with exercise reduces the risk of exercise-induced capillary leakage. In situations where intraalveolar pressure is reduced during inspiration, the capillary transmural gradient will be further increased and contribute to leakage from the capillaries to the interstitial and alveolar spaces.…”

Section: Pulmonary Venous and Arterial Pressure During Exercisementioning

confidence: 99%

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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Inter-individual differences in control of alveolar capillary blood volume in exercise and hypoxia

Cited by 17 publications

References 29 publications

Sex differences in respiratory and circulatory cost during hypoxic walking: potential impact on oxygen saturation

Sex differences in respiratory and circulatory cost during hypoxic walking: potential impact on oxygen saturation

Differences in alveolo-capillary equilibration in healthy subjects on facing O2 demand

Lung injury related to extreme environments

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