Decrease in pulmonary diffusion capacity after maximal exercise

Rasmussen, Bodil Steen; Hanel, Birgitte; Jensen, Kim Ebensgaard; Serup, Bent; Secher, Niels H.

doi:10.1080/02640418608732117

Cited by 37 publications

(27 citation statements)

References 7 publications

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“…Indirect evidence supports the theory of stress failure in the human BGB, including case studies of human athletes who have developed acute pulmonary edema as documented by chest radiography (28,44). Additionally, acute cough and oppression in the chest after maximal exercise are well-known phenomena after maximal rowing (32).…”

Section: Discussionmentioning

confidence: 84%

Maximal rowing has an acute effect on the blood-gas barrier in elite athletes

Hanel

Law²,

Mortensen³

2003

Journal of Applied Physiology

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Hanel, Birgitte, Ian Law, and Jann Mortensen. Maximal rowing has an acute effect on the blood-gas barrier in elite athletes. J Appl Physiol 95: 1076-1082, 2003. First published April 25, 2003 10.1152/japplphysiol.00082.2002The purpose of the study was to evaluate the effects of maximal exercise on the integrity of the alveolar epithelial membrane using the clearance rate of aerosolized 99m Tclabeled diethylenetriaminepentaacetic acid as an index for the permeability of the lung blood-gas barrier. Ten elite rowers (24.3 Ϯ 4.6 yr of age) completed two 20-min pulmonary clearance measurements immediately after and 2 h after 6 min of all-out rowing (initial and late, respectively). All subjects participated in resting control measurements on a separate day. For each 20-min measurement, lung clearance was calculated for 0-7 and 10-20 min. Furthermore, scintigrams were processed from the initial and late measurements of diethylenetriaminepentaacetic acid clearance. Compared with control levels, the pulmonary clearance measurement after rowing was increased from 1.2 Ϯ 0.5 to 2.4 Ϯ 1.0%/min (SD) at 0-7 min (P Ͻ 0.01) and from 0.8 Ϯ 0.3 to 1.5 Ϯ 0.4%/min at 10-20 min (P Ͻ 0.0005), returning to resting levels within 2 h. In 6 of 10 subjects, ventilation distribution on the lung scintigrams was inhomogeneous at the initial measurement. The study demonstrates an acute increased pulmonary clearance after maximal rowing. The ventilation defects identified on the lung scintigrams may represent transient interstitial edema secondary to increased blood-gas barrier permeability induced by mechanical stress. lung function; oarsmen; ventilation defects THERE IS EVIDENCE TO SUGGEST that the integrity of the lung blood-gas barrier (BGB) in elite athletes is altered after short-term maximal exercise (19). The finding of red blood cells and protein in the fluid of bronchoalveolar lavage suggests that this effect may be caused by mechanical stress on the alveolar capillary membrane. In contrast, sustained submaximal exercise [77% of maximal O 2 uptake (V O 2 max )] in elite athletes did not elicit the same ultrastructural changes (18). Hence, only extreme levels of exercise in elite athletes may disrupt the integrity of the BGB, with possibly secondary development of interstitial edema. During maximal exercise, the BGB is subjected to conflicting requirements. A thin barrier is most optimal for efficient gas exchange by diffusion, whereas a strong barrier is needed to withstand the increased pulmonary capillary pressure and the longitudinal tension in the alveolar wall associated with lung inflation (42). If any injury should occur, it may cause these layers to become leaky, thereby increasing permeability.A very sensitive method to evaluate the BGB permeability is measurement of the pulmonary clearance rate using 99m

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Section: Discussionmentioning

confidence: 84%

Maximal rowing has an acute effect on the blood-gas barrier in elite athletes

Hanel

Law²,

Mortensen³

2003

Journal of Applied Physiology

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“…In humans, the persistence of a reduction in Dl No after a marathon race, despite the fact that D LCO (impaired immediately after the race) and cardiac output returned to baseline values, was taken to reflect an exercise-induced impairment in pulmonary membrane diffusion (Manier et al 1991) that was linked putatively to a transient pulmonary interstitial edema. Moreover, impairments in resting D LCO have been reported following both high-intensity (Rasmussen et al 1986;Miles et al 1986;Rasmussen et al 1988Rasmussen et al , 1992Hanel et al 1994) and mild-intensity short-duration exercise (Hanel et al 1993), but little attempt was made to relate these observations to exercise-induced hypoxemia or oxyhemoglobin desaturation.…”

Section: Discussionmentioning

confidence: 99%

“…Measurements of pulmonary diffusion capacity (D L ) in these studies, however, have been obtained primarily under resting conditions either immediately, or several hours after, exercise. A decrease in D L has generally been reported following prolonged exercise (Miles et al 1983;Manier et al 1991), but results obtained following shortduration exercise are controversial, showing either a decrease (Miles et al 1983;Rasmussen et al 1986Rasmussen et al , 1988Manier et al 1991;Rasmussen et al 1992) or no change (Miles et al 1986;Miles and Schaefer 1988;Miles et al 1991;Manier et al 1993) in D L . In the present study D L was measured during short-duration high-intensity exercise in trained endurance athletes who systematically showed exercise-induced oxyhemoglobin desaturation, and a group of age-and V O 2max -matched endurance athletes who showed no exercise-induced oxyhemoglobin desaturation.…”

Section: Introductionmentioning

confidence: 99%

“…Because breathing a hyperoxic gas mixture has been shown to normalize this exercise-induced hypoxemia it has been suggested that pulmonary diffusion may also act as a contributing factor (Powers et al 1989b). Indeed, evidence for an excessive accumulation of extravascular lung water secondary to stress-induced, failure of pulmonary capillaries, which may contribute to the impairment of pulmonary diffusion, has been found in humans and other animals in response to high-intensity exercise (Rasmussen et al 1986(Rasmussen et al , 1988(Rasmussen et al , 1992Hanel et al 1994; or following prolonged exercise (Miles et al 1983;Manier et al 1991;Shaffartzik et al 1992). Measurements of pulmonary diffusion capacity (D L ) in these studies, however, have been obtained primarily under resting conditions either immediately, or several hours after, exercise.…”

Section: Introductionmentioning

confidence: 99%

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Exercise-induced oxyhemoglobin desaturation and pulmonary diffusing capacity during high-intensity exercise

Turcotte

Kiteala

Marcotte

et al. 1997

European Journal of Applied Physiology

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The purpose of this investigation was to examine if exercise-induced arterial oxyhemoglobin desaturation selectively observed in highly trained endurance athletes could be related to differences in the pulmonary diffusing capacity (DL) measured during exercise. The DL of 24 male endurance athletes was measured using a 3-s breath-hold carbon monoxide procedure (to give DLCO) at rest as well as during cycling at 60% and 90% of these previously determined VO2max. Oxyhemoglobin saturation (SaO2%) was monitored throughout both exercise protocols using an Ohmeda Biox II oximeter. Exercise-induced oxyhemoglobin desaturation (DS) (SaO2% < 91% at VO2max) was observed in 13 subjects [88.2 (0.6)%] but not in the other 11 nondesaturation subjects [NDS: 92.9 (0.4)%] (P < or = 0.05), although VO2max was not significantly different between the groups [DS: 4.34 (0.65) l/min vs NDS: 4.1 (0.49) l/min]. At rest, no differences in either DLCO [ml CO.mmHg-1.min-1: 41.7 (1.7) (DS) vs 41.1 (1.8) (NDS)], DLCO/VA [8.2 (0.4) (DS) vs 7.3 (0.9) (NDS)], MVV [l/min: 196.0 (10.4) (DS) vs 182.0 (9.9) (NDS)] or FEV1/FVC [86.3 (2.2) (DS) vs 82.9 (4.7) (NDS)] were found between groups (P > or = 0.05). However, VE/VO2 at VO2max was lower in the DS group [33.0 (1.1)] compared to the NDS group [36.8 (1.5)] (P < or = 0.05). Exercise DLCO (ml CO.mmHg-1.min-1) was not different between groups at either 60% VO2max [DS: 55.1 (1.4) vs NDS: 57.2 (2.1)] or at 90% VO2max [DS: 61.0 (1.8) vs NDS: 61.4 (2.9)]. A significant relationship (r = 0.698) was calculated to occur between SaO2% and VE/VO2 during maximal exercise. The present findings indicate that the exercise-induced oxyhemoglobin desaturation seen during submaximal and near-maximal exercise is not related to differences in DL, although during maximal exercise SaO2 may be limited by a relatively lower exercise ventilation.

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“…The reduction in DL CO in this late recovery phase after exercise is lower with submaximal exercise (Hanel et al. , 1993), and has been demonstrated after running, cycling and rowing (Rasmussen et al. , 1986; Hanel et al.…”

Section: Introductionmentioning

confidence: 91%

Postexercise reduction in lung diffusion capacity is not attenuated by skin cooling

Storebø

Hope²,

Vaagbø

et al. 2008

Clin Physio Funct Imaging

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Pulmonary diffusion capacity for carbon monoxide (DL(CO)) is reduced by approximately 10% 1-6 h after maximal exercise. The mechanisms may be interstitial alveolar oedema and reduced pulmonary capillary blood volume. It was hypothesized that thermal stress following exercise contributes to the reduction in DL(CO), and that skin cooling would attenuate the postexercise reduction in DL(CO). Cutaneous vascular conductance (CVC), mean surface temperature (MST), rectal temperature and DL(CO) were measured before and 90 min after maximal incremental cycle exercise. Thereafter, the subjects were exposed to cold air without eliciting shivering one day and another day served as control. The measurements were repeated 120 min after exercise. Twelve healthy subjects (six male) aged 20-27 years were studied. DL(CO) was reduced by 7.1% (SD = 6.3%, P = 0.003) and 7.6% (SD = 5.3%, P<0.001) 90 and 120 min after exercise in the control experiment. It was reduced by 5.6% (SD = 5.5%, P = 0.014) 90 min after exercise and remained reduced by 6.1% (SD = 6.1%, P = 0.012) after cooling despite a significant reduction in CVC and in MST from 31.9 (SD = 0.6) degrees C to 27.4 (SD = 1.9) degrees C. We conclude that the postexercise reduction in DL(CO) is present when thermal status is restored after exercise, and that it is not influenced by further skin surface cooling.

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Decrease in pulmonary diffusion capacity after maximal exercise

Cited by 37 publications

References 7 publications

Maximal rowing has an acute effect on the blood-gas barrier in elite athletes

Maximal rowing has an acute effect on the blood-gas barrier in elite athletes

Exercise-induced oxyhemoglobin desaturation and pulmonary diffusing capacity during high-intensity exercise

Postexercise reduction in lung diffusion capacity is not attenuated by skin cooling

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