Exercise induced hypervolemia is well documented following the initial onset of chronic exercise. In trained man, however, it might be difficult to induce further PV expansion with exercise induced hypervolemia already present. Therefore the primary goal of this study was determine the effect of acute high intensity exercise on plasma volume (PV), cardiac output (CO), stroke volume (SV), heart rate (HR), and oxygen consumption (VO2), in fourteen male competitive runners (VO2max 60.7 +/- 6.4 ml.kg-1.min-1) in the middle of their season. In this well trained state, subjects twice performed three steady state runs at different speeds, and one maximal graded exercise test (baseline). After this baseline evaluation, subjects exercised at a high intensity (approximately 90-95% of VO2max) on 2 consecutive days (short-term high intensity STHI exercise). Subjects then repeated the submaximal runs and maximal exercise test (post high intensity exercise, PHIE). Following the intense exercise period, the subjects experienced an increase in PV of 4.4% (p < 0.05), HR was significantly reduced for any given running speed (p < 0.05) as was blood lactate concentration (p < 0.05), and SV was significantly increased by 4% (p < 0.05). Both CO and VO2 at submaximal running speeds were unaffected by the acute increase in exercise intensity. Maximal HR was also significantly reduced following the intense exercise (p < 0.05), but VO2max was unchanged. These data illustrate that STHI exercise can induce a secondary hypervolemia at a given work rate in trained man. These findings support scientific and anecdotal reports of a reduced HR response at a given work rate PHIE.

Twenty-four insulin-dependent diabetic patients were interviewed immediately after a follow-up visit to an outpatient pediatric clinic to determine which of the recorded instructions delivered by professionals were recalled by patients. The health care team reported giving an average of seven recommendations per patient, or a total of 168 items listed by team members as important. Patients recalled an average of two recommendations, or a total of 50 items, 40% of which had not been recorded by team members. Recommendations concerning diet, insulin dosage and injections, urine testing, and exercise represented 80% of those recalled by patients and only 58% of those recorded by professionals. The results were interpreted to suggest that health care teams focus on fewer items to insure communication of the most appropriate recommendations for individual patients.

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