The effects of hyperthermia and hypoxia on ventilation during low-intensity steady-state exercise

Combining hypoxia with thermal stimuli in humans: physiological responses and potential sex differences

Increasing prevalence of native lowlanders sojourning to high altitudes (>2,500 m) for recreational, occupational, military, and competitive reasons has generated increased interest in physiological responses to multistressor environments. Exposure to hypoxia poses recognized physiological challenges that are amplified during exercise and further complicated by environments that might include combinations of heat, cold, and high altitude. There is a sparsity of data examining integrated responses in varied combinations of environmental conditions, with even less known about potential sex differences. How this translates into performance, occupational, and health outcomes requires further investigation. Acute hypoxic exposure decreases arterial oxygen saturation, resulting in a reflex hypoxic ventilatory response and sympathoexcitation causing an increase in heart rate, myocardial contractility, and arterial blood pressure, to compensate for the decreased arterial oxygen saturation. Acute altitude exposure impairs exercise performance, for example, reduced time to exhaustion and slower time trials, largely owing to impairments in pulmonary gas exchange and peripheral delivery resulting in reduced V̇o2max. This exacerbates with increasing altitude, as does the risk of developing acute mountain sickness and more serious altitude-related illnesses, but modulation of those risks with additional stressors is unclear. This review aims to summarize and evaluate current literature regarding cardiovascular, autonomic, and thermoregulatory responses to acute hypoxia, and how these may be affected by simultaneous thermal environmental challenges. There is minimal available information regarding sex as a biological variable in integrative responses to hypoxia or multistressor environments; we highlight these areas as current knowledge gaps and the need for future research.

Pulmonary ventilation and gas exchange during prolonged exercise in humans: Influence of dehydration, hyperthermia and sympathoadrenal activity

NEW FINDINGS

What is the central question of the study? Ventilation increases during prolonged intense exercise, but the impact of dehydration and hyperthermia, with associated blunting of pulmonary circulation, and independent influences of dehydration, hyperthermia and sympathoadrenal discharge on ventilatory and pulmonary gas exchange responses remain unclear. What is the main finding and its importance? Dehydration and hyperthermia led to hyperventilation and compensatory adjustments in pulmonary CO2 and O2 exchange, such that CO2 output increased and O2 uptake remained unchanged despite the blunted circulation. Isolated hyperthermia and adrenaline infusion, but not isolated dehydration, increased ventilation to levels similar to combined dehydration and hyperthermia. Hyperthermia is the main stimulus increasing ventilation during prolonged intense exercise, partly via sympathoadrenal activation.

ABSTRACT

The mechanisms driving hyperthermic hyperventilation during exercise are unclear. In a series of retrospective analyses, we evaluated the impact of combined versus isolated dehydration and hyperthermia and the effects of sympathoadrenal discharge on ventilation and pulmonary gas exchange during prolonged intense exercise. In the first study, endurance-trained males performed two submaximal cycling exercise trials in the heat. On day 1, participants cycled until volitional exhaustion (135 ± 11 min) while experiencing progressive dehydration and hyperthermia. On day 2, participants maintained euhydration and core temperature (Tc ) during a time-matched exercise (control). At rest and during the first 20 min of exercise, pulmonary ventilation (V ̇ E ${\skew2\dot V_{\rm{E}}}$ ), arterial blood gases, CO2 output and O2 uptake were similar in both trials. At 135 ± 11 min, however,V ̇ E ${\skew2\dot V_{\rm{E}}}$ was elevated with dehydration and hyperthermia, and this was accompanied by lower arterial partial pressure of CO2 , higher breathing frequency, arterial partial pressure of O2 , arteriovenous CO2 and O2 differences, and elevated CO2 output and unchanged O2 uptake despite a reduced pulmonary circulation. The increasedV ̇ E ${\skew2\dot V_{\rm{E}}}$ was closely related to the rise in Tc and circulating catecholamines (R2  ≥ 0.818, P ≤ 0.034). In three additional studies in different participants, hyperthermia independently increasedV ̇ E ${\skew2\dot V_{\rm{E}}}$ to an extent similar to combined dehydration and hyperthermia, whereas prevention of hyperthermia in dehydrated individuals restoredV ̇ E ${\skew2\dot V_{\rm{E}}}$ to control levels. Furthermore, adrenaline infusion during exercise elevated both Tc andV ̇ E ${\skew2\dot V_{\rm{E}}}$ . These findings indicate that: (1) adjustments in pulmonary gas exchange limit homeostatic disturbances in the face of a blunted pulmonary circulation; (2) hyperthermia is the main stimulus increasing ventilation during prolonged intense exercise; and (3) sympathoadrenal activation might partly mediate the hyperthermic hyperventilation.

Carotid body hyperexcitability underlies heat-induced hyperventilation in exercising humans

Physical activity is the most common source of heat strain for humans. The thermal strain of physical activity causes overbreathing (hyperventilation) and this has adverse physiological repercussions. The mechanisms underlying heat-induced hyperventilation during exercise are unknown, but recent evidence supports a primary role of carotid body hyperexcitability (increased tonic activity and sensitivity) underpinning hyperventilation in passively heated humans. In a repeated-measures crossover design, 12 healthy participants (6 female) completed two low-intensity cycling exercise conditions (25% maximal aerobic power) in randomized order, one with core temperature (T_C) kept relatively stable near thermoneutrality, and the other with progressive heat strain to +2°C T_C. To provide a complete examination of carotid body function under graded heat strain, carotid body tonic activity was assessed indirectly by transient hyperoxia, and its sensitivity estimated by responses to both isocapnic and poikilocapnic hypoxia. Carotid body tonic activity was increased by 220 ± 110% during cycling alone, and by 400 ± 290% with supplemental thermal strain to +1°C T_C, and 600 ± 290% at +2°C T_C (interaction, P = 0.0031). During exercise with heat stress at both +1°C and +2°C T_C, carotid body suppression by hyperoxia decreased ventilation below the rates observed during exercise without heat stress (P < 0.0147). Carotid body sensitivity was increased by up to 230 ± 190% with exercise alone, and by 290 ± 250% with supplemental heating to +1°C T_C and 510 ± 470% at +2°C T_C (interaction, P = 0.0012). These data indicate that the carotid body is further activated and sensitized by heat strain during exercise and this largely explains the added drive to breathe.NEW & NOTEWORTHY Physical activity is the most common way humans increase their core temperature, and excess breathing in the heat can limit heat tolerance and performance, and may increase the risk of heat-related injury. Dose-dependent increases in carotid body tonic activity and sensitivity with core heating provide compelling evidence that carotid body hyperexcitability is the primary cause of heat-induced hyperventilation during exercise.

Physiological Function during Exercise and Environmental Stress in Humans-An Integrative View of Body Systems and Homeostasis

Claude Bernard’s milieu intérieur (internal environment) and the associated concept of homeostasis are fundamental to the understanding of the physiological responses to exercise and environmental stress. Maintenance of cellular homeostasis is thought to happen during exercise through the precise matching of cellular energetic demand and supply, and the production and clearance of metabolic by-products. The mind-boggling number of molecular and cellular pathways and the host of tissues and organ systems involved in the processes sustaining locomotion, however, necessitate an integrative examination of the body’s physiological systems. This integrative approach can be used to identify whether function and cellular homeostasis are maintained or compromised during exercise. In this review, we discuss the responses of the human brain, the lungs, the heart, and the skeletal muscles to the varying physiological demands of exercise and environmental stress. Multiple alterations in physiological function and differential homeostatic adjustments occur when people undertake strenuous exercise with and without thermal stress. These adjustments can include: hyperthermia; hyperventilation; cardiovascular strain with restrictions in brain, muscle, skin and visceral organs blood flow; greater reliance on muscle glycogen and cellular metabolism; alterations in neural activity; and, in some conditions, compromised muscle metabolism and aerobic capacity. Oxygen supply to the human brain is also blunted during intense exercise, but global cerebral metabolism and central neural drive are preserved or enhanced. In contrast to the strain seen during severe exercise and environmental stress, a steady state is maintained when humans exercise at intensities and in environmental conditions that require a small fraction of the functional capacity. The impact of exercise and environmental stress upon whole-body functions and homeostasis therefore depends on the functional needs and differs across organ systems.

Global REACH 2018: The influence of acute and chronic hypoxia on cerebral haemodynamics and related functional outcomes during cold and heat stress

KEY POINTS

Thermal and hypoxic stress commonly coexist in environmental, occupational and clinical settings, yet how the brain tolerates these multi-stressor environments is unknown Core cooling by 1.0°C reduced cerebral blood flow (CBF) by 20-30% and cerebral oxygen delivery (CDO₂ ) by 12-19% at sea level and high altitude, whereas core heating by 1.5°C did not reliably reduce CBF or CDO₂ Oxygen content in arterial blood was fully restored with acclimatisation to 4330 m, but concurrent cold stress reduced CBF and CDO₂ Gross indices of cognition were not impaired by any combination of thermal and hypoxic stress despite large reductions in CDO₂ Chronic hypoxia renders the brain susceptible to large reductions in oxygen delivery with concurrent cold stress, which might make monitoring core temperature more important in this context ABSTRACT: Real-world settings are composed of multiple environmental stressors, yet the majority of research in environmental physiology investigates these stressors in isolation. The brain is central in both behavioural and physiological responses to threatening stimuli and, given its tight metabolic and haemodynamic requirements, is particularly susceptible to environmental stress. We measured cerebral blood flow (CBF, duplex ultrasound), cerebral oxygen delivery (CDO₂ ), oesophageal temperature, and arterial blood gases during exposure to three commonly experienced environmental stressors - heat, cold and hypoxia - in isolation, and in combination. Twelve healthy male subjects (27 ± 11 years) underwent core cooling by 1.0°C and core heating by 1.5°C in randomised order at sea level; acute hypoxia ( P ET , O 2  = 50 mm Hg) was imposed at baseline and at each thermal extreme. Core cooling and heating protocols were repeated after 16 ± 4 days residing at 4330 m to investigate any interactions with high altitude acclimatisation. Cold stress decreased CBF by 20-30% and CDO₂ by 12-19% (both P < 0.01) irrespective of altitude, whereas heating did not reliably change either CBF or CDO₂ (both P > 0.08). The increases in CBF with acute hypoxia during thermal stress were appropriate to maintain CDO₂ at normothermic, normoxic values. Reaction time was faster and slower by 6-9% with heating and cooling, respectively (both P < 0.01), but central (brain) processes were not impaired by any combination of environmental stressors. These findings highlight the powerful influence of core cooling in reducing CDO₂ . Despite these large reductions in CDO₂ with cold stress, gross indices of cognition remained stable.

Rating of perceived exertion increases synergistically during prolonged exercise in a combined heat and hypoxic environment

The purpose of this study was to determine the cardiovascular, thermoregulatory, and perceived exertion responses during 2 h of moderate intensity exercise in a combined high heat (38 ^°C, 40% relative humidity) and hypoxic (15% O₂) environment. Ten healthy volunteers completed 2 h of treadmill walking at 40% of maximal oxygen uptake in four different conditions, each separated by approximately 1 week: (1) control, 23 ^°C/20.9% O₂, (2) heat, 38 ^°C/20.9% O₂, (3) hypoxia, 23 ^°C/15% O_2, and (4) combined heat/hypoxia, 38 ^°C/15% O₂. Compared to the responses seen in each condition alone, heart rate (HR) and core temperature (T_core) showed an additive increase in the combined heat and hypoxic environment after 2 h of moderate intensity exercise. The most important new finding was that the mean rating of perceived exertion (RPE) increased synergistically 3.3 units when exercising in the combined high heat and hypoxic environment, compared to 1.9 units in the heat condition alone. The results suggest that RPE is a conscious perception of effort that plays a regulatory function to ensure that the work rate remains at an intensity that can be safely sustained, rather than simply a marker of exercise intensity. Such results also support previous anecdotal reports that exercise on hot days at altitude seem unusually difficult.

Respiratory mechanics and cerebral blood flow during heat-induced hyperventilation and its voluntary suppression in passively heated humans

We investigated whether heat-induced hyperventilation can be voluntarily prevented, and, if so, how this modulates respiratory mechanics and cerebral blood flow in resting heated humans. In two separate trials, 10 healthy men were passively heated using lower body hot-water immersion and a water-perfused garment covering their upper body (both 41°C) until esophageal temperature (Tes ) reached 39°C or volitional termination. In each trial, participants breathed normally (normal-breathing) or voluntarily controlled minute ventilation (VE ) at a level equivalent to that observed after 5 min of heating (controlled-breathing). Respiratory gases, middle cerebral artery blood velocity (MCAV), work of breathing, and end-expiratory and inspiratory lung volumes were measured. During normal-breathing, VE increased as Tes rose above 38.0 ± 0.3°C, whereas controlled-breathing diminished the increase in VE (VE at Tes  = 38.6°C: 25.6 ± 5.9 and 11.9 ± 1.3 L min-1 during normal- and controlled-breathing, respectively, P < 0.001). During normal-breathing, end-tidal CO2 pressure and MCAV decreased with rising Tes , but controlled-breathing diminished these reductions (at Tes  = 38.6°C, 24.7 ± 5.0 vs. 39.5 ± 2.8 mmHg; 44.9 ± 5.9 vs. 60.2 ± 6.3 cm sec-1 , both P < 0.001). The work of breathing correlated positively with changes in VE (P < 0.001) and was lower during controlled- than normal-breathing (16.1 ± 12.6 and 59.4 ± 49.5 J min-1 , respectively, at heating termination, P = 0.013). End-expiratory and inspiratory lung volumes did not differ between trials (P = 0.25 and 0.71, respectively). These results suggest that during passive heating at rest, heat-induced hyperventilation increases the work of breathing without affecting end-expiratory lung volume, and that voluntary control of breathing can nearly abolish this hyperventilation, thereby diminishing hypocapnia, cerebral hypoperfusion, and increased work of breathing.

Variable role of carotid bodies in cardiovascular responses to exercise, hypoxia and hypercapnia in spontaneously hypertensive rats

KEY POINTS

Carotid bodies play a critical role in maintaining arterial pressure during hypoxia and this has important implications when considering resection therapy of the carotid body in disease states such as hypertension. Curbing hypertension in patients whether resting or under stress remains a major global health challenge. We demonstrated previously the benefits of removing carotid body afferent input into the brain for both alleviating sympathetic overdrive and reducing blood pressure in neurogenic hypertension. We describe a new approach in rats for selective ablation of the carotid bodies that spares the functional integrity of the carotid sinus baroreceptors, and demonstrate the importance of the carotid bodies in the haemodynamic response to forced exercise, hypoxia and hypercapnia in conditions of hypertension. Selective ablation reduced blood pressure in hypertensive rats and re-set baroreceptor reflex function accordingly; the increases in blood pressure seen during exercise, hypoxia and hypercapnia were unaffected, abolished and augmented, respectively, after selective carotid body removal. The data suggest that carotid body ablation may trigger potential cardiovascular risks particularly during hypoxia and hypercapnia and that suppression rather than obliteration of their activity may be a more effective and safer route to pursue.

ABSTRACT

The carotid body has recently emerged as a promising therapeutic target for treating cardiovascular disease, but the potential impact of carotid body removal on the dynamic cardiovascular responses to acute stressors such as exercise, hypoxia and hypercapnia in hypertension is an important safety consideration that has not been studied. We first validated a novel surgical approach to selectively resect the carotid bodies bilaterally (CBR) sparing the carotid sinus baroreflex. Second, we evaluated the impact of CBR on the cardiovascular responses to exercise, hypoxia and hypercapnia in conscious, chronically instrumented spontaneously hypertensive (SH) rats. The results confirm that our CBR technique successfully and selectively abolished the chemoreflex, whilst preserving carotid baroreflex function. CBR produced a sustained fall in arterial pressure in the SH rat of ∼20 mmHg that persisted across both dark and light phases (P < 0.001), with baroreflex function curves resetting around lower arterial pressure levels. The cardiovascular and respiratory responses to moderate forced exercise were similar between CBR and Sham rats. In contrast, CBR abolished the pressor response to hypoxia seen in Sham animals, although the increases in heart rate and respiration were similar between Sham and CBR groups. Both the pressor and the respiratory responses to 7% hypercapnia were augmented after CBR (P < 0.05) compared to sham. Our finding that the carotid bodies play a critical role in maintaining arterial pressure during hypoxia has important implications when considering resection therapy of the carotid body in disease states such as hypertension as well as heart failure with sleep apnoea.

Panting as a human heat loss thermoeffector

The human autonomic nervous system participates in the control of thermoregulatory responses that are employed to regulate core temperature following deviations of skin temperature and/or core temperature from their respective resting values. This permits a regulation of the core temperature (T_C) at 37.0 ± 1°C with superimposed circadian variations in both sexes and menstrual cycle-associated variations in premenopausal women. When rendered hyperthermic, passively by heat exposure while at rest or actively during exercise, humans engage heat loss or thermolytic responses, including eccrine sweating and cutaneous vasodilatation. A third, less studied, human thermolytic response is thermal panting, and this response is the focus of this review. Human thermal panting was first described over a century ago. It has since been shown to be a reproducible response showing some similar patterns of breathing in species that employ panting as their sole thermolytic heat loss response. The contribution of human panting as a thermolytic response, however, remains controversial. This review highlights both past and recent evidence supporting that hyperthermic humans have a panting pattern of breathing that plays an important role in human thermoregulation.

The human ventilatory response to stress: rate or depth?

Many stressors cause an increase in ventilation in humans. This is predominantly reported as an increase in minute ventilation (V̇E). But, the same V̇E can be achieved by a wide variety of changes in the depth (tidal volume, V_T ) and number of breaths (respiratory frequency, ƒ_R ). This review investigates the impact of stressors including: cold, heat, hypoxia, pain and panic on the contributions of ƒ_R and V_T to V̇E to see if they differ with different stressors. Where possible we also consider the potential mechanisms that underpin the responses identified, and propose mechanisms by which differences in ƒ_R and V_T are mediated. Our aim being to consider if there is an overall differential control of ƒ_R and V_T that applies in a wide range of conditions. We consider moderating factors, including exercise, sex, intensity and duration of stimuli. For the stressors reviewed, as the stress becomes extreme V̇E generally becomes increased more by ƒ_R than V_T . We also present some tentative evidence that the pattern of ƒ_R and V_T could provide some useful diagnostic information for a variety of clinical conditions. In The Physiological Society's year of 'Making Sense of Stress', this review has wide-ranging implications that are not limited to one discipline, but are integrative and relevant for physiology, psychophysiology, neuroscience and pathophysiology.

Cardiorespiratory control and cytokine profile in response to heat stress, hypoxia, and lipopolysaccharide (LPS) exposure during early neonatal period

Sudden infant death syndrome (SIDS) is one of the most common causes of postneonatal infant mortality in the developed world. An insufficient cardiorespiratory response to multiple environmental stressors (such as prone sleeping positioning, overwrapping, and infection), during a critical period of development in a vulnerable infant, may result in SIDS. However, the effect of multiple risk factors on cardiorespiratory responses has rarely been tested experimentally. Therefore, this study aimed to quantify the independent and possible interactive effects of infection, hyperthermia, and hypoxia on cardiorespiratory control in rats during the neonatal period. We hypothesized that lipopolysaccharide (LPS) administration will negatively impact cardiorespiratory responses to increased ambient temperature and hypoxia in neonatal rats. Sprague-Dawley neonatal rat pups were studied at postnatal day 6-8. Rats were examined at an ambient temperature of 33°C or 38°C. Within each group, rats were allocated to control, saline, or LPS (200 μg/kg) treatments. Cardiorespiratory and thermal responses were recorded and analyzed before, during, and after a hypoxic exposure (10% O2). Serum samples were taken at the end of each experiment to measure cytokine concentrations. LPS significantly increased cytokine concentrations (such as TNFα, IL-1β, MCP-1, and IL-10) compared to control. Our results do not support a three-way interaction between experimental factors on cardiorespiratory control. However, independently, heat stress decreased minute ventilation during normoxia and increased the hypoxic ventilatory response. Furthermore, LPS decreased hypoxia-induced tachycardia. Herein, we provide an extensive serum cytokine profile under various experimental conditions and new evidence that neonatal cardiorespiratory responses are adversely affected by dual interactions of environmental stress factors.

Diurnal variation in the control of ventilation in response to rising body temperature during exercise in the heat

We investigated whether heat-induced hyperventilation during exercise is affected by time of day, as diurnal variation leads to higher core temperatures in the evening. Nineteen male subjects were divided into two experiments (protocol 1, n = 10 and protocol 2, n = 9). In protocol 1, subjects performed cycle exercise at 50% peak oxygen uptake in the heat (37°C and 50% RH) in the morning (0600) and evening (1800). Results showed that baseline resting and exercising esophageal temperature (Tes) were significantly (0.5°C) higher in the evening than morning. Minute ventilation (V̇e) increased from 54.3 ± 7.9 and 54.9 ± 6.8 l/min at 10 min to 71.4 ± 8.1 and 76.5 ± 11.8 l/min at 48.5 min in the morning and evening, respectively (both P < 0.01). Time of day had no effect on V̇e (P = 0.44). When V̇e as the output response was plotted against Tes as thermal input, the Tes threshold for increases in V̇e was higher in the evening than morning (37.2 ± 0.7 vs. 36.6 ± 0.6°C, P = 0.009), indicating the ventilatory response to the same core temperature is smaller in the evening. In protocol 2, the circadian rhythm-related higher resting Tes seen in the evening was adjusted down to the same temperature seen in the morning by immersing the subject in cold water. Importantly, the time course of changes in V̇e during exercise were smaller in the evening, but the threshold for V̇e remained higher in the evening than morning (P < 0.001). Collectively, those results suggest that time of day has no effect on time course hyperventilation during exercise in the heat, despite the higher core temperatures in the evening. This is likely due to diurnal variation in the control of ventilation in response to rising core temperature.

Cerebral Vascular Control and Metabolism in Heat Stress

This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced peripheral resistance secondary to skin vasodilatation. Therefore, when hyperthermia is combined with conditions that increase cardiovascular strain, for example, orthostasis or dehydration, the inability to preserve cerebral perfusion pressure further reduces CBF. A reduced cerebral perfusion pressure is in turn the primary mechanism for impaired tolerance to orthostatic challenges. Any reduction in CBF attenuates the brain's convective heat loss, while the hyperthermic-induced increase in metabolic rate increases the cerebral heat gain. This paradoxical uncoupling of CBF to metabolism increases brain temperature, and potentiates a condition whereby cerebral oxygenation may be compromised. With levels of experimentally viable passive hyperthermia (up to 39.5-40.0 °C core temperature), the associated reduction in CBF (∼ 30%) and increase in cerebral metabolic demand (∼ 10%) is likely compensated by increases in cerebral oxygen extraction. However, severe increases in whole-body and brain temperature may increase blood-brain barrier permeability, potentially leading to cerebral vasogenic edema. The cerebrovascular challenges associated with hyperthermia are of paramount importance for populations with compromised thermoregulatory control--for example, spinal cord injury, elderly, and those with preexisting cardiovascular diseases.

Characteristics of hyperthermia-induced hyperventilation in humans

In humans, hyperthermia leads to activation of a set of thermoregulatory responses that includes cutaneous vasodilation and sweating. Hyperthermia also increases ventilation in humans, as is observed in panting dogs, but the physiological significance and characteristics of the hyperventilatory response in humans remain unclear. The relative contribution of respiratory heat loss to total heat loss in a hot environment in humans is small, and this hyperventilation causes a concomitant reduction in arterial CO₂ pressure (hypocapnia), which can cause cerebral hypoperfusion. Consequently, hyperventilation in humans may not contribute to the maintenance of physiological homeostasis (i.e., thermoregulation). To gain some insight into the physiological significance of hyperthermia-induced hyperventilation in humans, in this review, we discuss 1) the mechanisms underlying hyperthermia-induced hyperventilation, 2) the factors modulating this response, and 3) the physiological consequences of the response.

Effects of elevated core temperature and normoxic 30% nitrous oxide on human ventilation during short duration, high intensity exercise

It was hypothesized that normoxic 30% nitrous oxide (N2O) would suppress and hyperthermia would increase exercise ventilation during short duration, high intensity exercise. Thirteen males (24.2±0.8y; mean±SE), of normal physique (BMI, 23.8±1.0kgm(-2)), performed 4 separate 30s Wingate tests on a cycle ergometer. Exercise ventilation and its components, as well as mean skin and esophageal temperature (TES), were assessed in 2 way experimental design with factors of Thermal State (Normothermia or Hyperthermia) and Gas Type (Air or 30% Normomoxic N2O). In the 2 hyperthermic tests TES was elevated to ∼38.5°C in a 40°C bath. The main results indicated a significant interaction (F=7.14, P=0.02) between Gas Type and Thermal state for the exercise-induced increase in ventilation (ΔV˙E). During both the normothermia and hyperthermia conditions with AIR breathing, the exercise ΔV˙E was ∼80Lmin(-1) and it was significantly decreased to 73.1±24.1Lmin(-1) in the normothermia condition with N2O breathing relative to that of 92.0±25.0Lmin(-1) in the hyperthermia condition with N2O breathing. In conclusion, normoxic N2O breathing suppressed high intensity exercise ventilation during normothermia relative to that during hyperthermia on account of decreases in the tidal volume and this led CO2 retention.

Comparison of hyperthermic hyperventilation during passive heating and prolonged light and moderate exercise in the heat

Elevation of core temperature leads to increases in ventilation in both resting subjects and those engaged in prolonged exercise. We compared the characteristics of the hyperthermic hyperventilation elicited during passive heating at rest and during prolonged moderate and light exercise. Twelve healthy men performed three trials: a rest trial in which subjects were passively heated using hot-water immersion (41°C) and a water-perfused suit and two exercise trials in which subjects exercised at 25% (light) or 50% (moderate) of peak oxygen uptake in the heat (37°C and 50% relative humidity) after first using water immersion (18°C) to reduce resting esophageal temperature (T(es)). This protocol enabled detection of a T(es) threshold for hyperventilation during the exercise. When minute ventilation (Ve) was expressed as a function of T(es), 9 of the 12 subjects showed T(es) thresholds for hyperventilation in all trials. The T(es) thresholds for increases in Ve during light and moderate exercise (37.1 ± 0.4 and 36.9 ± 0.4°C) were both significantly lower than during rest (38.3 ± 0.6°C), but the T(es) thresholds did not differ between the two exercise intensities. The sensitivity of Ve to increasing T(es) (slope of the T(es)-Ve relation) above the threshold was significantly lower during moderate exercise (8.7 ± 3.5 l · min(-1) · °C(-1)) than during rest (32.5 ± 24.2 l · min(-1) · °C(-1)), but the sensitivity did not differ between light (10.4 ± 13.0 l · min(-1) · °C(-1)) and moderate exercise. These results suggest the core temperature threshold for hyperthermic hyperventilation and the hyperventilatory response to increasing core temperature in passively heated subjects differs from that in exercising subjects, irrespective of whether the exercise is moderate or light.

The challenge of performing aerobic exercise in tropical environments: applied knowledge and perspectives

The tropical climate is unique in that the seasons are dominated by the movement of the tropical rain belt, resulting in dry and wet seasons rather than the four-season pattern of changes in temperature and day length seen in other parts of the world. More than 33% of the world population lives in the humid tropics, which are characterized by consistently high monthly temperatures and rainfall that exceeds evapotranspiration for most days of the year. Both the 2014 Football World Cup (in Brazil) and the 2016 Olympic Games (in Rio de Janeiro) will take place in this climate. This review focuses on the effects of the tropical environment on human exercise performance, with a special emphasis on prolonged aerobic exercise, such as swimming, cycling, and running. Some of the data were collected in Guadeloupe, the French West Indies Island where all the French teams will be training for the 2016 Olympic Games. We will first fully define the tropical climate and its effects on performance in these sports. Then we will discuss the types of adaptation that help to enhance performance in this climate, as well as the issues concerning the prescription of adequate training loads. We will conclude with some perspectives for future research.

Central chemoreflex ventilatory responses in humans following passive heat acclimation

Since there is temperature dependence of pulmonary ventilation (V˙(E)) in response to the normal modulators (i.e. [Formula: see text] , [Formula: see text] ), it was asked in this study if passive heat acclimation (HA) modifies the human central chemoreflex ventilatory response to CO(2). Nine males performed normothermic- and hyperthermic modified Read re-breathing tests before and after HA. Heat acclimation consisted of 2hday(-1) exposures to 50°C and 20% RH for 10 consecutive days and each exposure elevated rectal temperature to between 38.5 and 39.0°C. Ventilatory recruitment thresholds (VRTs) and central chemosensitivity were assessed before and after HA during normothermia with an oesophageal temperature (T(es)) of ∼37°C and in hyperthermia when T(es) was 38.5-39.0°C. Results showed VRT and central chemosensitivities were unaltered by HA (p≥0.375) and hyperthermia increased pre- (p=0.010) but not post-acclimation (p=0.332) central chemosensitivity. Additionally, during hyperthermia V˙(E) became progressively greater (p=0.027) relative to corresponding normothermic values in the re-breathing tests. In conclusion, the ventilatory response to hyperoxic CO(2) was unaltered by heat Acclimation State.

Short-term exercise-heat acclimation enhances skin vasodilation but not hyperthermic hyperpnea in humans exercising in a hot environment

We tested the hypothesis that short-term exercise-heat acclimation (EHA) attenuates hyperthermia-induced hyperventilation in humans exercising in a hot environment. Twenty-one male subjects were divided into the two groups: control (C, n = 11) and EHA (n = 10). Subjects in C performed exercise-heat tests [cycle exercise for ~75 min at 58% [Formula: see text] (37°C, 50% relative humidity)] before and after a 6-day interval with no training, while subjects in EHA performed the tests before and after exercise training in a hot environment (37°C). The training entailed four 20-min bouts of exercise at 50% [Formula: see text] separated by 10 min of rest daily for 6 days. In C, comparison of the variables recorded before and after the no-training period revealed no changes. In EHA, the training increased resting plasma volume, while it reduced esophageal temperature (T (es)), heart rate at rest and during exercise, and arterial blood pressure and oxygen uptake ([Formula: see text]) during exercise. The training lowered the T (es) threshold for increasing forearm vascular conductance (FVC), while it increased the slope relating FVC to T (es) and the peak FVC during exercise. It also lowered minute ventilation ([Formula: see text]) during exercise, but this effect disappeared after removing the influence of [Formula: see text] on [Formula: see text]. The training did not change the slope relating ventilatory variables to T (es). We conclude that short-term EHA lowers ventilation largely by reducing metabolism, but it does not affect the sensitivity of hyperthermia-induced hyperventilation during submaximal, moderate-intensity exercise in humans.

No effect of skin temperature on human ventilation response to hypercapnia during light exercise with a normothermic core temperature

Hyperthermia potentiates the influence of CO(2) on pulmonary ventilation (.V(E)). It remains to be resolved how skin and core temperatures contribute to the elevated exercise ventilation response to CO(2). This study was conducted to assess the influences of mean skin temperature (_T(SK)) and end-tidal PCO(2) (P(ET)CO(2)) on .V(E) during submaximal exercise with a normothermic esophageal temperature (T(ES)). Five males and three females who were 1.76 +/- 0.11 m tall (mean +/- SD), 75.8 +/- 15.6 kg in weight and 22.0 +/- 2.2 years of age performed three 1 h exercise trials in a climatic chamber with the relative humidity (RH) held at 31.5 +/- 9.5% and the ambient temperature (T (AMB)) maintained at one of 25, 30, or 35 degrees C. In each trial, the volunteer breathed eucapnic air for 5 min during a rest period and subsequently cycle ergometer exercised at 50 W until T (ES) stabilized at approximately 37.1 +/- 0.4 degrees C. Once T (ES) stabilized in each trial, the volunteer breathed hypercapnic air twice for approximately 5 min with P(ET)CO(2) elevated by approximately +4 or +7.5 mmHg. The significantly (P < 0.05) different increases of P(ET)CO(2) of +4.20 +/- 0.49 and +7.40 +/- 0.51 mmHg gave proportionately larger increases in .V(E) of 10.9 +/- 3.6 and 15.2 +/- 3.6 L min(-1) (P = 0.001). This hypercapnia-induced hyperventilation was uninfluenced by varying the _T(SK) to three significantly different levels (P < 0.001) of 33.2 +/- 1.2 degrees C, to 34.5 +/- 0.8 degrees C to 36.4 +/- 0.5 degrees C. In conclusion, the results support that skin temperature between approximately 33 and approximately 36 degrees C has neither effect on pulmonary ventilation nor on hypercapnia-induced hyperventilation during a light exercise with a normothermic core temperature.

Adaptation of exercise ventilation during an actively-induced hyperthermia following passive heat acclimation

Hyperthermia-induced hyperventilation has been proposed to be a human thermolytic thermoregulatory response and to contribute to the disproportionate increase in exercise ventilation (V̇e) relative to metabolic needs during high-intensity exercise. In this study it was hypothesized that V̇e would adapt similar to human eccrine sweating (ĖSW) following a passive heat acclimation (HA). All participants performed an incremental exercise test on a cycle ergometer from rest to exhaustion before and after a 10-day passive exposure for 2 h/day to either 50°C and 20% relative humidity (RH) ( n = 8, Acclimation group) or 24°C and 32% RH ( n = 4, Control group). Attainment of HA was confirmed by a significant decrease ( P = 0.025) of the esophageal temperature (Tes) threshold for the onset of ĖSW and a significantly elevated ĖSW ( P ≤ 0.040) during the post-HA exercise tests. HA also gave a significant decrease in resting Tes ( P = 0.006) and a significant increase in plasma volume ( P = 0.005). Ventilatory adaptations during exercise tests following HA included significantly decreased Tes thresholds ( P ≤ 0.005) for the onset of increases in the ventilatory equivalents for O2 (V̇e/V̇o2) and CO2 (V̇e/V̇co2) and a significantly increased V̇e ( P ≤ 0.017) at all levels of Tes. Elevated V̇e was a function of a significantly greater tidal volume ( P = 0.003) at lower Tes and of breathing frequency ( P ≤ 0.005) at higher Tes. Following HA, the ventilatory threshold was uninfluenced and the relationships between V̇o2 and either V̇e/V̇o2 or V̇e/V̇co2 did not explain the resulting hyperventilation. In conclusion, the results support that exercise V̇e following passive HA responds similarly to ĖSW, and the mechanism accounting for this adaptation is independent of changes of the ventilatory threshold or relationships between V̇o2 with each of V̇e/V̇o2 and V̇e/V̇co2.

Effects of chemoreflexes on hyperthermic hyperventilation and cerebral blood velocity in resting heated humans

We tested the hypothesis that hyperthermic hyperventilation in part reflects enhanced chemoreceptor ventilatory O(2) drive, and that the resultant hypocapnia attenuates ventilatory responses and/or middle cerebral artery mean blood velocity (MCAV(mean)) in resting humans. Eleven healthy subjects were passively heated for 50-80 min, causing oesophageal temperature (T(oes)) to increase by 1.6 degrees C. During heating, minute ventilation increased (P < 0.05), while end-tidal CO(2) pressure (P(ET,CO(2))) and MCAV(mean) declined. A hyperoxia test in which three breaths of hyperoxic air were inspired was performed once before heating and three times during the heating. When we observed hypocapnia (P(ET,CO(2)) below 40 mmHg), P(ET,CO(2)) was restored to the eucapnic level by adding 100% CO(2) to the inspired air immediately before the last two tests. Minute ventilation was significantly reduced by hyperoxia, and that reduction gradually increased with increasing T(oes). However, the percentage decrease in from the normoxic level was small (20-29%) and unchanged during heating. When P(ET,CO(2)) was restored to eucapnic levels, was unchanged, but MCAV(mean) was partly restored to the level seen prior to heating (28.1% restoration at T(oes) 37.6 degrees C and 38.1% restoration at T(oes) 38.0 degrees C). These findings suggest that although hyperthermia increases chemoreceptor ventilatory O(2) drive in resting humans, the relative contribution of the chemoreceptor ventilatory O(2) drive to hyperthermic hyperventilation is small ( approximately 20%) and unaffected by increasing core temperature. Moreover, hypocapnia induced by hyperthermic hyperventilation reduces cerebral blood flow but not ventilatory responses.

Influence of passive hyperthermia on human ventilation during rest and isocapnic hypoxia

The purpose of this study was to examine the potential interaction of core temperature and isocapnic hypoxia on human ventilation and heart rate (HR). In 2 resting head-out water-immersion trials, 8 males first breathed air and then 12% O2in N2while the end-tidal partial pressure of carbon dioxide was kept 0.98 (0.66) mmHg (mean (SD)) above normothermic resting levels. The first immersion trial was with a normothermic esophageal temperature (Tes) of ~36.7 °C, and for the second trial, 1 h later, water temperature was increased to give a hyperthermic Tesof ~38.2 °C. Isocapnic hypoxia increased normothermic ventilation by 4 L·min–1(p = 0.01) from 10.12 (1.07) to 14.20 (3.21) L·min–1, and hyperthermic ventiliation by 7 L·min–1(p = 0.002) from 13.58 (2.58) to 20.79 (3.73) L·min–1. Ventilation increases during hyperthermia were mediated by breathing frequency and, during isocapnic hypoxia, by tidal volume. Unexpectedly, there was an absence of any hypoxic ventilatory decline that could be attributed to a hydrostatic effect of immersion. Isocapnic hypoxia increased the HR by similar amounts of ~10 and ~11 beats·min–1in normothermia and hyperthermia, respectively. In conclusion, it appears that hyperthermia increases human ventilatory but not heart rate responses to isocapnic hypoxia.

Thermoregulation: some concepts have changed. Functional architecture of the thermoregulatory system

While summarizing the current understanding of how body temperature (Tb) is regulated, this review discusses the recent progress in the following areas: central and peripheral thermosensitivity and temperature-activated transient receptor potential (TRP) channels; afferent neuronal pathways from peripheral thermosensors; and efferent thermoeffector pathways. It is proposed that activation of temperature-sensitive TRP channels is a mechanism of peripheral thermosensitivity. Special attention is paid to the functional architecture of the thermoregulatory system. The notion that deep Tb is regulated by a unified system with a single controller is rejected. It is proposed that Tb is regulated by independent thermoeffector loops, each having its own afferent and efferent branches. The activity of each thermoeffector is triggered by a unique combination of shell and core Tbs. Temperature-dependent phase transitions in thermosensory neurons cause sequential activation of all neurons of the corresponding thermoeffector loop and eventually a thermoeffector response. No computation of an integrated Tb or its comparison with an obvious or hidden set point of a unified system is necessary. Coordination between thermoeffectors is achieved through their common controlled variable, Tb. The described model incorporates Kobayashi’s views, but Kobayashi’s proposal to eliminate the term sensor is rejected. A case against the term set point is also made. Because this term is historically associated with a unified control system, it is more misleading than informative. The term balance point is proposed to designate the regulated level of Tb and to attract attention to the multiple feedback, feedforward, and open-loop components that contribute to thermal balance.