Validity of oxygen uptake measurements during exercise under moderate hyperoxia

Does Oxygen Uptake Before Physical Exercise Affect Tear Osmolarity?

Recently, it has been reported that tear osmolarity (Tosm) is correlated with plasma osmolarity and will increase during exertion. We aimed to assess whether inhaling oxygen-enriched air between exercises could significantly change the Tosm value. Thirty men aged 24.9 years were included in the study. A cycloergometer was used to perform the exercise protocol. We recorded the participants’ Tosm (mOsm/L), heart rate (HR, beats/minute), oxygen saturation, and blood pressure values. After the first exhaustive exercise (T1), participants inhaled oxygen in the experimental group and a placebo in the control group. After the second exercise (T2), another set of measurements was obtained. The Tosm value before exercise was 297.4 ± 1.21 and 296.53 ± 1.11 mOsm/L (p = 0.61718) and the HR was 72.6 ± 2.59 and 73 ± 2.59 beats/minute (p = 0.39949) in the study and the control group, respectively. At T1, Tosm was 303.67 ± 1.25 and 302.2 ± 1.25 mOsm/L (p = 0.41286) and the HR reached 178.04 ± 2.60 and 176.4 ± 2.60 beats/minute (p = 0.65832), respectively. At T2, Tosm in the study group reached 305.73 ± 0.86 mOsm/L (correlation with the use of oxygen: r = −0.3818), and in the control group, it was 308.4 ± 0.86 mOsm/L (p = 0.0373), while the HR reached 172.20 ± 2.53 beats/minute in the study group and 178.2 ± 2.53 beats/minute in the control group (p = 0.057). It was concluded that inhaling oxygen before and after exercise could increase the rate of recovery after exhaustive exercise.

Thermoregulatory and cardiovasculareffects of capsaicin application on human skin during dynamic exercise to temperate and warm conditions

Thermoregulatory and cardiovascular responses during cycling in temperate and warm environments without and with application of capsaicin on the skin were investigated. We hypothesized that regardless of environmental temperature, capsaicin application would activate heat loss mechanisms attenuating exercise‐induced rectal temperature (Tre) and blood pressure increase. Eight males cycled at 55% of their maximal aerobic power so long as to reach 38.2°C Tre at 20.8 ± 1.0°C and at 30.6 ± 1.1°C ambient temperatures twice: without (NCA) and with (CA) application of capsaicin patches (12 × 18 cm, 4.8 mg). Patches were applied on pectoralis major, trapezius and vastus lateralis muscles. Thermoregulatory (Tre, proximal‐distal skin temperature gradient, sweating rate), cardiovascular variables and oxygen uptake were continuously recorded. In both ambient conditions, during the first 14 min of exercise, the local vasoconstrictive tone as a function of the relative change in Tre was lower in CA than NCA (p < .05, d = 0.84–1.15). Further, sweating rate was higher and occurred at a lower Tre increase in CA compared to NCA (p = .03, d = 0.6) resulting in extended time to reach 38.2°C Tre (p = .03, d = 0.9). Moreover, oxygen consumption was higher in CA than in NCA (p < .001, d = 0.8). Mean arterial pressure was lower during cycling in warm compared to temperate environment, but was unaffected by capsaicin. We conclude that activation of thermal sensors by capsaicin results in lower Tre rise during exercise, which is mediated through greater skin vasodilation along with higher rate and earlier onset of sweating. Nonetheless, capsaicin application has no extra effect on exercise cardiovascular responses.

Altered amplitude of low-frequency fluctuation in basal ganglia correlates to pulmonary ventilation function in COPD patients: A resting-state fMRI study

INTRODUCTION

Patients under chronic obstructive pulmonary disease (COPD) has been reported to be associated with a higher prevalence of cognitive impairment (CI). However, it is still largely unknown whether the aberrant resting-state spontaneous neuronal activity pattern reflected by the amplitude of low-frequency fluctuation (ALFF) analysis will be associated with the CI in COPD patients.

MATERIALS

A total of 28 COPD patients and 26 healthy controls were enrolled in this study. Of all the subjects, structural and functional MRI data, spirometry tests performance and neuropsychological assessments of different cognitive domains were collected. Voxel-based two-sample t tests were used to detect brain regions showing differences in the ALFF value between COPD patients and healthy controls. An additional fMRI runs with supplementary oxygen delivery were employed to explore the impact of elevated partial pressure of oxygen (PaO₂ ) or moderate hyperoxia on ALFF in COPD patients and healthy controls respectively.

RESULTS

More extensive white matter lesion was detected in COPD patients. COPD patients exhibit decreased ALFF value in bilateral basal ganglia areas and right thalamus, and aberrant ALFF value is correlated with PaO₂ and pulmonary ventilation function (FEV1%pred). COPD patients performed worse in the Digit Span Test (reverse), Digit Symbol Substitution Test, Trail-making test (A and B) than controls. After supplementary oxygen inhalation, the ALFF value of basal ganglia and right thalamus significantly increased in the controls, but not in the COPD patients.

CONCLUSIONS

COPD patients mainly exhibit impaired executive function but not long-term memory in cognitive function assessment. Aberrant ALFF alteration in the deep brain may be directly related to lower PaO₂ in COPD patients.

Test-retest variability of VO2max using total-capture indirect calorimetry reveals linear relationship of VO2 and Power

This study aimed to analyze the intra‐individual variation in VO_2max of human subjects using total‐capture and free‐flow indirect calorimetry. Twenty‐seven men (27 ± 5 year; VO_2max 49‐79 mL•kg⁻¹•min⁻¹) performed two maximal exertion tests (CPETs) on a cycle ergometer, separated by a 7 ± 2 day interval. VO₂ and VCO₂ were assessed using an indirect calorimeter (Omnical) with total capture of exhalation in a free‐flow airstream. Thirteen subjects performed a third maximal exertion test using a breath‐by‐breath calorimeter (Oxycon Pro). On‐site validation was deemed a requirement. For the Omnical, the mean within‐subject CV for VO_2max was 1.2 ± 0.9% (0.0%‐4.4%) and for ergometer workload P_max 1.3 ± 1.3% (0%‐4.6%). VO_2max values with the Oxycon Pro were significantly lower in comparison with Omnical (P < 0.001; t test) with mean 3570 vs 4061 and difference SD 361 mL•min⁻¹. Validation results for the Omnical with methanol combustion were −0.05 ± 0.70% (mean ± SD; n = 31) at the 225 mL•min⁻¹ VO₂ level and −0.23 ± 0.80% (n = 31) at the 150 mL•min⁻¹ VCO₂ level. Results using gas infusion were 0.04 ± 0.75% (n = 34) and −0.99 ± 1.05% (n = 24) over the respective 500‐6000 mL•min⁻¹ VO₂ and VCO₂ ranges. Validation results for the Oxycon Pro in breath‐by‐breath mode were ‐ 2.2 ± 1.6% (n = 12) for VO₂ and 5.7 ± 3.3% (n = 12) for VCO₂ over the 1000‐4000 mL•min⁻¹ range. On a Visual analog scale, participants reported improved breathing using the free‐flow indirect calorimetry (score 7.6 ± 1.2 vs 5.1 ± 2.7, P = 0.008). We conclude that total capturing free‐flow indirect calorimetry is suitable for measuring VO₂ even with the highest range. VO_2max was linear with the incline in P_max over the full range.

No acetyl group deficit is evident at the onset of exercise at 90% of maximal oxygen uptake in humans

The existence of an acetyl group deficit at or above 90% of maximal oxygen uptake (VO(2max)) has proved controversial, with contradictory results likely relating to limitations in previous research. The purpose of the present study was to determine whether the "acetyl group deficit" occurs at the start of exercise at 90%VO(2max) in a well-controlled study. Eight male participants (age: 33.6 +/- 2.0 years; VO(2max): 3.60 +/- 0.21 litres . min(-1)) completed two exercise bouts at 90%VO(2max) for 3 min following either 30 min of saline (control) or dichloroacetate (50 mg . kg(-1) body mass) infusion, ending 15 min before exercise. Muscle biopsies were obtained immediately before and after exercise while continuous non-invasive measures of pulmonary oxygen uptake and muscle deoxygenation were made. Muscle pyruvate dehydrogenase activity was significantly higher before exercise following dichloroacetate infusion (control: 2.67 +/- 0.98 vs. dichloroacetate: 17.9 +/- 1.1 mmol acetyl-CoA . min(-1) . mg(-1) protein, P = 0.01) and resulted in higher pre- and post-exercise muscle acetylcarnitine (pre-exercise control: 3.3 +/- 0.95 vs. pre-exercise dichloroacetate: 8.0 +/- 0.88 vs. post-exercise control: 11.9 +/- 1.1 vs. post-exercise dichloroacetate: 17.2 +/- 1.1 mmol . kg(-1) dry muscle, P < 0.05). However, substrate-level phosphorylation (control: 125 +/- 20 vs. dichloroacetate: 113 +/- 13 mmol adenosine triphosphate . kg(-1) dry muscle) and VO(2) kinetics (control: 19.2 +/- 2.2 vs. dichloroacetate: 22.8 +/- 2.5 s), were unaltered. Furthermore, dichloroacetate infusion blunted the slow component of VO(2) and muscle deoxygenation and slowed muscle deoxygenation kinetics, possibly by enhancing oxygen delivery during exercise. These data support the hypothesis that the "acetyl group deficit" does not occur at or above 90%VO(2max).

Gas analyzer's drift leads to systematic error in maximal oxygen uptake and maximal respiratory exchange ratio determination

The aim was to examine the drift in the measurements of fractional concentration of oxygen (FO2) and carbon dioxide (FCO2) of a Nafion-using metabolic cart during incremental maximal exercise in 18 young and 12 elderly males, and to propose a way in which the drift can be corrected. The drift was verified by comparing the pre-test calibration values with the immediate post-test verification values of the calibration gases. The system demonstrated an average downscale drift (P < 0.001) in FO2 and FCO2 of -0.18% and -0.05%, respectively. Compared with measured values, corrected average maximal oxygen uptakevalues were 5-6% lower (P < 0.001) whereas corrected maximal respiratory exchange ratio values were 8-9% higher (P < 0.001). The drift was not due to an electronic instability in the analyzers because it was reverted after 20 min of recovery from the end of the exercise. The drift may be related to an incomplete removal of water vapor from the expired gas during transit through the Nafion conducting tube. These data demonstrate the importance of checking FO2 and FCO2 values by regular pre-test calibrations and post-test verifications, and also the importance of correcting a possible shift immediately after exercise.

Exhaled nitric oxide concentration in the period of 60 min after submaximal exercise in the cold

BACKGROUND

Fractional expired nitric oxide (FENO ) is decreased after exercise. The effect of exercise in the cold upon FENO is unknown.

PURPOSE

To examine changes in FENO after a short, high intensive exercise test in a cold and in a temperate environment.

METHODS

Twenty healthy well-trained subjects (eight females) aged 18-28 years performed an 8-min exercise test at 18°C (SD = 1.0) and -10°C (SD = 1.2) ambient temperature. The tests were performed in a climate chamber in random order. The workload corresponded to 90-95% of peak heart rate (HRpeak ) during the last 4 min. FENO was measured offline. Exhaled gas was sampled in Mylar(®) bags using a collector kit with a flow restrictor and analysed within 2 h. FENO was measured before exercise and repeatedly during the first hour after. ANOVA for repeated measures was used to compare differences in FENO after exercise between environments.

RESULTS

There was no difference in baseline FENO . A significant difference in FENO between environments was found after warm-up and from 20 to 30 min after exercise, with FENO being lower after exercise in the cold (P<0.05). The maximal reduction in FENO was seen 5 min after exercise and was not different between environments.

CONCLUSION

Recovery of FENO was slower after exercising in -10°C compared with 18°C.

Comparison of the Cosmed K4b(2) portable metabolic system in measuring steady-state walking energy expenditure

Background and Aims

Recent introduction of the Cosmed K4b² portable metabolic analyzer allows measurement of oxygen consumption outside of a laboratory setting in more typical clinical or household environments and thus may be used to obtain information on the metabolic costs of specific daily life activities. The purpose of this study was to assess the accuracy of the Cosmed K4b² portable metabolic analyzer against a traditional, stationary gas exchange system (the Medgraphics D-Series) during steady-state, submaximal walking exercise.

Methods

Nineteen men and women (9 women, 10 men) with an average age of 39.8 years (±13.8) completed two 400 meter walk tests using the two systems at a constant, self-selected pace on a treadmill. Average oxygen consumption (VO₂) and carbon dioxide production (VCO₂) from each walk were compared.

Results

Intraclass Correlation Coefficient (ICC) and Pearson correlation coefficients between the two systems for weight indexed VO₂ (ml/kg/min), total VO₂ (ml/min), and VCO₂ (ml/min) ranged from 0.93 to 0.97. Comparison of the average values obtained using the Cosmed K4b² and Medgraphics systems using paired t-tests indicate no significant difference for VO₂ (ml/kg/min) overall (p = 0.25), or when stratified by sex (p = 0.21 women, p = 0.69 men). The mean difference between analyzers was – 0.296 ml/kg/min (±0.26). Results were not significantly different for VO₂ (ml/min) or VCO₂ (ml/min) within the study population (p = 0.16 and p = 0.08, respectively), or when stratified by sex (VO₂: p = 0.51 women, p = 0.16 men; VCO₂: p = .11 women, p = 0.53 men).

Conclusion

The Cosmed K4b² portable metabolic analyzer provides measures of VO₂ and VCO₂ during steady-state, submaximal exercise similar to a traditional, stationary gas exchange system.

No effect of glutamine supplementation and hyperoxia on oxidative metabolism and performance during high-intensity exercise

Glutamine enhances the exercise-induced expansion of the tricarboxylic acid intermediate pool. The aim of the present study was to determine whether oral glutamine, alone or in combination with hyperoxia, influenced oxidative metabolism and cycle time-trial performance. Eight participants consumed either placebo or 0.125 g kg body mass(-1) of glutamine in 5 ml kg body mass(-1) placebo 1 h before exercise in normoxic (control and glutamine respectively) or hyperoxic (FiO(2) = 50%; hyperoxia and hyperoxia + glutamine respectively) conditions. Participants then cycled for 6 min at 70% maximal oxygen uptake (VO(2max)) immediately before completing a brief high-intensity time-trial (approximately 4 min) during which a pre-determined volume of work was completed as fast as possible. The increment in pulmonary oxygen uptake during the performance test (DeltaVO(2max), P = 0.02) and exercise performance (control: 243 s, s(x) = 7; glutamine: 242 s, s(x) = 3; hyperoxia: 231 s, s(x) = 3; hyperoxia + glutamine: 228 s, s(x) = 5; P < 0.01) were significantly improved in hyperoxic conditions. There was some evidence that glutamine ingestion increased DeltaVO(2max) in normoxia, but not hyperoxia (interaction drink/FiO(2), P = 0.04), but there was no main effect or impact on performance. Overall, the data show no effect of glutamine ingestion either alone or in combination with hyperoxia, and thus no limiting effect of the tricarboxylic acid intermediate pool size, on oxidative metabolism and performance during maximal exercise.

Influence of hyperoxia on pulmonary O2 uptake kinetics following the onset of exercise in humans

The purpose of this study was to examine the influence of hyperoxic gas (50% O2 in N2) inspiration on pulmonary oxygen uptake (V(O2)) kinetics during step transitions to moderate, severe and supra-maximal intensity cycle exercise. Seven healthy male subjects completed repeat transitions to moderate (90% of the gas exchange threshold, GET), severe (70% of the difference between the GET and V(O2) peak) and supra-maximal (105% V(O2) peak) intensity work rates while breathing either normoxic (N) or hyperoxic (H) gas before and during exercise. Hyperoxia had no significant effect on the Phase II V(O2) time constant during moderate (N: 28+/-3s versus H: 31+/-7s), severe (N: 32+/-9s versus H: 33+/-6s) or supra-maximal (N: 37+/-9s versus H: 37+/-9s) exercise. Hyperoxia resulted in a 45% reduction in the amplitude of the V(O2) slow component during severe exercise (N: 0.60+/-0.21 L min(-1) versus H: 0.33+/-0.17 L min(-1); P < 0.05) and a 15% extension of time to exhaustion during supra-maximal exercise (N: 173+/-28 s versus H: 198+/-41 s; P < 0.05). These results indicate that the Phase II V(O2) kinetics are not normally constrained by (diffusional) O2 transport limitations during moderate, severe or supra-maximal intensity exercise in young healthy subjects performing upright cycle exercise.

Validity and reliability of selected commercially available metabolic analyzer systems

Automated metabolic gas analysis systems have advanced considerably over the past decade. They provide an abundance of information, which is not possible by using the traditional Douglas bag method and have become an essential tool in both physiological monitoring and in the diagnosis of cardiopulmonary disease. The validity and reliability of the different online metabolic analyzer systems are not well known, with relatively few independent studies being published. The purpose of this review was to examine and evaluate current literature regarding the validity and reliability of commercially available metabolic analyzer systems. This review reveals significant differences between the available systems in the way that they capture and process basic respiratory measurements. Online metabolic analyzer systems were found to vary significantly when compared with Douglas bag methods. These variations have the potential to introduce error into the accuracy with which the health of cardiovascular system can be assessed or training loads can be assigned. Compounding this is the fact that many automated systems are a "black box", which makes it easy to generate data without the user having much understanding of how the data were generated. In conclusion automated metabolic analyser systems are a scientifically robust method for the evaluation of cardiopulmonary function. Individual researchers and clinicians must, however, be able to make their own decisions about the level of error that is tolerable for their individual needs. This presents a significant practical challenge in light of the speed with which technical developments in the field occur and we make some suggestions for the formulation of intersystem comparison studies.

Effect of hyperoxia on maximal O2 uptake in exercise-induced arterial hypoxaemic subjects

This study focuses on the effect of hyperoxia on maximal oxygen uptake VO2max and maximal power (Pmax) in subjects exhibiting exercise-induced arterial hypoxemia (EIH) at sea level. Sixteen competing male cyclists VO2max > 60 ml.min(-1).kg(-1)) performed exhaustive ramp exercise (cycle-ergometer) under normoxia and moderate hyperoxia (FIO2 = 30%). After the normoxic trial, the subjects were divided into those demonstrating EIH during exercise [arterial O2 desaturation (delta SaO2) >5%; n = 9] and those who did not (n = 7). Under hyperoxia, SaO2 raised and the increase was greater for the EIH than for the non-EIH group (P<0.001). VO2max improved for both groups and to a greater extent for EIH (12.8 +/- 5.7% vs. 4.2 +/- 4.6%, P<0.01; mean+/-SD) and the increase was correlated to the gain in SaO2 for all subjects (r = 0.71, P<0.01). Pmax improved by 3.3 +/- 3.3% (P<0.01) regardless of the group. These data suggest that pulmonary gas exchange contributes to a limitation in VO2max and power for especially EIH subjects.

Acute hyperoxaemia-induced effects on regional blood flow, oxygen consumption and central circulation in man

AIM

Despite numerous in vitro and animal studies, circulatory effects and mechanisms responsible for the vasoconstriction seen during hyperoxaemia are yet to be ascertained. The present study set out to: (i) set up a non-invasive human model for the study of hyperoxia-induced cardiovascular effects, (ii) describe the dynamics of this effect and (iii) determine whether hyperoxaemia also, by vasoconstriction alters oxygen consumption (O(2)).

METHODS

The study comprised four experiments (A, B, C and D) on healthy volunteers examined before, during and after 100% oxygen breathing. A: Blood flow (mL min(-1).100 mL(-1) tissue), venous occlusion plethysmography was assessed (n = 12). B: Blood flow was recorded with increasing transcutaneous oxygen tension (P(tc)O(2)) levels (dose-response) (n = 8). C: Heart rate (HR), stroke volume, cardiac output (CO) and systemic vascular resistance (SVR) was assessed using echocardiography (n = 8). D: O(2) was measured using an open circuit technique when breathing an air-O(2) mix (fraction of inhaled oxygen: F(i)O(2) = 0.58) (n = 8).

RESULTS

Calf blood flow decreased 30% during O(2) breathing. The decrease in calf blood flow was found to be oxygen dose dependent. A similar magnitude, as for the peripheral circulation, of the effect on central parameters (HR/CO and SVR) and in the time relationship was noted. Hyperoxia did not change O(2). An average of 207 (93) mL O(2) per subject was washed in during the experiments.

CONCLUSION

This model appears suitable for the investigation of O(2)-related effects on the central and peripheral circulation in man. Our findings, based on a more comprehensive (central/peripheral circulation examination) evaluation than earlier made, suggest significant circulatory effects of hyperoxia. Further studies are warranted to elucidate the underlying mechanisms.

A high blood lactate induced by heavy exercise does not affect the increase in submaximal VO2 with hyperoxia

Few studies evidenced an enhancement in oxygen uptake (VO2) during submaximal exercise in hyperoxia. This O2 "overconsumption" seems to increase above the lactate threshold. The aim of this study was to determine whether the hyperoxia-induced enhancement in VO2 may be related to a higher metabolism of lactate. Nine healthy males (aged 23.1 years, mean VO2 max= 53.8 ml min-1 kg-1) were randomized to two series of exercise in either normoxia or hyperoxia corresponding to an inspired O2 fraction (FIO2) of 30%. Each series consisted of 6 min cycling at 50% VO2 max (Moderate1), 5 min cycling at 95%VO2 max (Near Max) and then 6 min at 50% VO2 max (Moderate2). In both series Near Max was performed in normoxia. VO2 was significantly greater under hyperoxia than in normoxia during Moderate1 (2192 +/- 189 vs. 2025 +/- 172 ml min-1) and during Moderate2 (2352 +/- 173 vs. 2180+ /- 193 ml min-1). However, the effect of the high FIO2 was not significantly different on VO2Moderate2 (+172+/-137 ml min-1 with [La] approximately 6 mmol l-1) compared to VO2Moderate1 (+166 +/- 133 ml min-1 with [La] approximately 2.4 mmol l-1). [La] at the onset of Moderate2 was not different between normoxia and hyperoxia (10.1 +/- 2.2 vs. 10.9 +/- 1.6 mmol l-1). The results show that VO2 is significantly increased during moderate exercise in hyperoxia. But this O2 overconsumption was not modified by a high [La] induced by a prior heavy exercise. It could be concluded that lactate accumulation is not directly responsible for the increase in O2 overconsumption with intensity during exercise in hyperoxia.