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Andrew C Bulmer

Publications and source records attributed to Andrew C Bulmer.

2 recordsLinked to original sources

Arterial oxygen desaturation kinetics during apnea.

PURPOSE: To quantify the rate of arterial oxygen desaturation during apnea in freedivers. METHODS: Ten freedivers and ten controls undertook five maximal face immersion apneas in 10 degrees C water separated by 2 min of recovery. Electrocardiogram (ECG), blood pressure, and pulse oximetry were recorded continuously. Peripheral blood flow was measured by calf plethysmography every 30 s, and venous blood samples were collected at rest and after apneas 1, 3, and 5. The blood was analyzed for hematocrit (Hct), lactate, and hemoglobin (Hb) concentration. The arterial oxygen saturation (SaO(2)) data were curve fitted with both a sigmoid and two-slope continuous function. RESULTS: Apnea duration increased with successive attempts, with freedivers achieving significantly longer maximal apneas (trained 246 +/- 44 s, untrained 129 +/- 39 s, P < 0.001). Compared with controls, freedivers displayed a significant change from baseline in heart rate (trained -27.2 +/- 9.5 bpm, untrained -19.7 +/- 9.3 bpm, P < 0.001) and mean arterial pressure (MAP) (trained 48 +/- 20.7 mm Hg, untrained 37 +/- 10.0 mm Hg, P = 0.002), but no difference existed in peripheral blood flow, Hct, lactate, or Hb. The maximal slope of the SaO(2) sigmoid curve was not significantly different between the groups (trained -0.16 +/- 0.05%.s(-1), untrained -0.15 +/- 0.06%.s(-1), P = 0.26), but the DeltaSaO(2(/Deltat obtained from the two-slope continuous model indicated that 85% of the variance in the freedivers DeltaSaO(2)/Deltat could be explained by the apnea-induced bradycardia, preapnea vital capacity, and Hb concentration. CONCLUSIONS: The sigmoidal function provided no quantifiable difference in the rate of oxygen desaturation. The two-slope continuous method, however, indicated that freedivers who had larger oxygen stores and produced the largest bradycardia were able to slow the DeltaSaO(2)/Deltat to two to three times that of the least marked response.

Adult↗

Optimising exercise training in peripheral arterial disease.

Peripheral arterial disease (PAD) is an obstructive condition where the flow of blood through peripheral arteries is impeded. During periods of increased oxygen demand (e.g. during exercise), peripheral limb ischaemia occurs, resulting in the sensation of muscle pain termed 'claudication'. As a result of claudication, subjects' ability to exercise is greatly reduced affecting their quality of life. Although many treatment options for patients with PAD exist, exercise training is an effective and low-cost means of improving functional ability and quality of life. Currently, there are limited specific recommendations to assist the exercise prescription and programming of these individuals. This review summarises data from 28 exercise training studies conducted in patients with PAD and formulates recommendations based on their results. Exercise training for patients with PAD should involve three training sessions per week comprising 45 minutes of intermittent treadmill walking in a supervised environment for a time period of 20 weeks or more. Encouragement and direction is given to further research aimed at investigating the effectiveness of training programmes in these patients.

Exercise↗