Bronchodilators accelerate the dynamics of muscle O2 delivery and utilisation during exercise in COPD

Berton, Danilo Cortozi; Barbosa, Priscila; Takara, Luciana S.; Chiappa, Gaspar R.; Siqueira, Ana Cristina B.; Bravo, Daniela M.; Ferreira, Leonardo F.; Neder, J. Alberto

doi:10.1136/thx.2009.120857

Cited by 58 publications

(61 citation statements)

References 35 publications

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“…Authors concluded that unloading the respiratory muscles decreased their perfusion, allowing more blood flow to the skeletal muscles and a greater exercise power at the same total cardiac output (233). Additional studies, unloading the respiratory muscles by means of heliox breathing, proportional assisted ventilation and inhaled bronchodilators during constant-load exercise in COPD have suggested improved peripheral muscle oxygen delivery as that was either inferred by near-infrared spectroscopy-determined kinetic analysis of tissue oxygenation indices (31,35), or by decreasing approximately 30% to 40% the exercise-induced limb muscle fatigue (21). Faster cardiac-output kinetic responses following heliox and bronchodilator administration were also interpreted as an alleviation of disturbances imposed by the mechanics of breathing (31).…”

Section: Blood Flow Redistributionmentioning

confidence: 94%

Factors Limiting Exercise Tolerance in Chronic Lung Diseases

Vogiatzis

Zakynthinos

2012

Comprehensive Physiology

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The major limitation to exercise performance in patients with chronic lung diseases is an issue of great importance since identifying the factors that prevent these patients from carrying out activities of daily living provides an important perspective for the choice of the appropriate therapeutic strategy. The factors that limit exercise capacity may be different in patients with different disease entities (i.e., chronic obstructive, restrictive or pulmonary vascular lung disease) or disease severity and ultimately depend on the degree of malfunction or miss coordination between the different physiological systems (i.e., respiratory, cardiovascular and peripheral muscles). This review focuses on patients with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and pulmonary vascular disease (PVD). ILD and PVD are included because there is sufficient experimental evidence for the factors that limit exercise capacity and because these disorders are representative of restrictive and pulmonary vascular disorders, respectively. A great deal of emphasis is given, however, to causes of exercise intolerance in COPD mainly because of the plethora of research findings that have been published in this area and also because exercise intolerance in COPD has been used as a model for understanding the interactions of different pathophysiologic mechanisms in exercise limitation. As exercise intolerance in COPD is recognized as being multifactorial, the impacts of the following factors on patients' exercise capacity are explored from an integrative physiological perspective: (i) imbalance between the ventilatory capacity and requirement; (ii) imbalance between energy demands and supplies to working respiratory and peripheral muscles; and (iii) peripheral muscle intrinsic dysfunction/weakness.

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Section: Blood Flow Redistributionmentioning

confidence: 94%

Factors Limiting Exercise Tolerance in Chronic Lung Diseases

Vogiatzis

Zakynthinos

2012

Comprehensive Physiology

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“…NIRS has been used to examine the effect of bronchodilators [46] and oxygen [47,48] administration on the improvement of attenuated oxygen delivery to the muscle in patients with chronic obstructive pulmonary disease (see [49] for review). NIRS has also been used to examine the effect of pharmacological treatment on blunted microvascular oxygen delivery to the muscle [50] and the effect of a rehabilitation programme on muscle oxygenation [51] in patients with chronic heart failure.…”

Section: (D) Examples Of Recent Advanced Near-infrared Spectroscopy Amentioning

confidence: 99%

The use of muscle near-infrared spectroscopy in sport, health and medical sciences: recent developments

Hamaoka

McCully

Niwayama

et al. 2011

Phil. Trans. R. Soc. A.

154

136

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Near-infrared spectroscopy (NIRS) has been shown to be one of the tools that can measure oxygenation in muscle and other tissues in vivo. This review paper highlights the progress, specifically in this decade, that has been made for evaluating skeletal muscle oxygenation and oxidative energy metabolism in sport, health and clinical sciences. Development of NIRS technologies has focused on improving quantification of the signal using multiple wavelengths to solve for absorption and scattering coefficients, multiple pathlengths to correct for the influence of superficial skin and fat, and time-resolved and phase-modulated light sources to determine optical pathlengths. In addition, advances in optical imaging with multiple source and detector pairs as well as portability using small wireless detectors have expanded the usefulness of the devices. NIRS measurements have provided information on oxidative metabolism in various athletes during localized exercise and whole-body exercise, as well as training-induced adaptations. Furthermore, NIRS technology has been used in the study of a number of chronic health conditions. Future developments of NIRS technology will include enhancing signal quantification. In addition, advances in NIRS imaging and portability promise to transform how measurements of oxygen utilization are obtained in the future.

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“…NIRS technology has been applied to the study of a number of chronic health conditions, including patients with COPD. Such studies have investigated the impact of the pulmonary system limitations on locomotor muscle fatigue in patients with COPD (490)(491)(492). Collectively, these studies (491)(492)(493) have shown that respiratory muscle unloading (via oxygen and/or heliox breathing, bronchodilation, and proportional-assist ventilation) improves leg muscle oxygen availability during exercise in patients with COPD.…”

Section: Assessment Of Muscle Oxygenation Using Near-infrared and Magmentioning

confidence: 99%

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

Maltais¹,

Decramer²,

Casaburi³

et al. 2014

Am J Respir Crit Care Med

887

1,033

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Bronchodilators accelerate the dynamics of muscle O2 delivery and utilisation during exercise in COPD

Cited by 58 publications

References 35 publications

Factors Limiting Exercise Tolerance in Chronic Lung Diseases

Factors Limiting Exercise Tolerance in Chronic Lung Diseases

The use of muscle near-infrared spectroscopy in sport, health and medical sciences: recent developments

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

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