Biomedical subjects

Gerald S Zavorsky

Publications and source records attributed to Gerald S Zavorsky.

11 recordsLinked to original sources

PubMed2006

Short-term variability of nitric oxide diffusing capacity and its components.

When monitoring nitric oxide diffusing capacity (DL(NO)) in patients, it is necessary to distinguish natural biological variation from a real change in alveolar-membrane conductance. The short-term variability of single-breath DL(NO) has not been established. The aim was to determine the short-term variability DL(NO) in healthy subjects. Twelve healthy subjects performed single-breath hold diffusing capacity tests at rest over a 2-month period (eight separate sessions with 8+/-3 days between each session). Each subject inhaled 41+/-4 ppm NO and a standard diffusion mixture. DL(NO), which is a multiple of the membrane diffusing capacity for carbon monoxide (Dm(CO)), as well as carbon monoxide diffusing capacity (DL(CO)) and pulmonary capillary blood volume (V(c)) remained unaltered over the 2-month period (P>0.05). Reproducibility (calculated as 2.77 multiplied by the within-subject standard deviation) over eight sessions was 20, 5 and 8 mL min(-1)mmHg(-1) for DL(NO), DL(CO) and Dm(CO), respectively, and 19 mL for V(c) (when Dm(CO)=DL(NO)/2.42). DL(NO), DL(CO), Dm(CO) and V(c) remain unchanged over a period of 2 months. Since the inter-session variability is 20, 5 and 8 mL min(-1)mmHg(-1) for DL(NO), DL(CO) and Dm(CO), and 19 mL for V(c), a meaningful change should equal or exceed those values. While there is a small chance that week-to-week variation can also be partly due to mild pathophysiological changes, any differences that are below the reproducibility values are likely to be natural biological variation or technical variation of the equipment, rather than true physiological change.

Adult↗

PubMed2006

Potassium kinetics and its relationship with ventilation during repeated bouts of exercise in women.

The purpose of this study was to determine the electrolyte concentration changes in arterial plasma from high-intensity repeated bouts of cycling exercise in well-trained females and to determine the relationships between arterial plasma lactate, potassium (K+), bicarbonate (HCO3(-)), and pH with minute ventilation. Fourteen female subjects (mean age = 27 +/- 4 years; mean height = 170 +/- 7 cm; mean weight = 62 +/- 7 kg; maximal oxygen uptake = 50 +/- 6 ml/kg/min) were recruited to perform 3 x 5 min bouts of exercise at 236 +/- 27 W with 10 min recovery between each set. Minute ventilation, arterial plasma lactate, potassium, calcium, chloride, and sodium ion concentrations were measured a minute 0, 1, 2, 3, 4, 5 of each set and midway through recovery (21 sampling points total per subject). The results showed that the strongest relationship was between arterial plasma K+ concentration and minute ventilation (r2 = 0.91), and, that arterial plasma lactate mirrored both arterial plasma HCO3(-) and pH. In conclusion, this study demonstrates that women exhibit similar electrolyte responses as reported elsewhere in men, and support the idea that K+ may partly contribute to controlling ventilation during high-intensity exercise and recovery.

Adult↗

PubMed2006

Arterial versus capillary blood gases: a meta-analysis.

A meta-analysis determined whether capillary blood gases accurately reflect arterial blood samples. A mixed effects model was used on 29 relevant studies obtained from a PubMed/Medline search. From 664 and 222 paired samples obtained from the earlobe and fingertip, respectively, earlobe compared to fingertip sampling shows that the standard deviation of the difference is about 2.5x less (or the precision is 2.5x better) in resembling arterial PO(2) over a wide range of arterial PO(2)'s (21-155 mm Hg ). The lower the arterial PO(2), the more accurate it is when predicting arterial PO(2) from any capillary sample (p<0.05). However, while earlobe sampling predicts arterial PO(2) (adjusted r(2)=0.88, mean bias=3.8 mm Hg compared to arterial), fingertip sampling does not (adjusted r(2)=0.48, mean bias=11.5 mm Hg compared to arterial). Earlobe sampling is slightly more accurate compared to fingertip sampling in resembling arterial PCO(2) (arterial versus earlobe, adjusted r(2)=0.94, mean bias=1.9 mm Hg ; arterial versus fingertip, adjusted r(2)=0.95, mean bias=2.2 mm Hg compared to arterial) but both sites can closely reflect arterial PCO(2) (880 total paired samples, range 10-114 mm Hg ). No real difference between sampling from the earlobe or fingertip were found for pH as both sites accurately reflect arterial pH over a wide range of pH (587 total paired samples, range 6.77-7.74, adjusted r(2)=0.90-0.94, mean bias=0.02). In conclusion, sampling blood from the fingertip or earlobe (preferably) accurately reflects arterial PCO(2) and pH over a wide range of values. Sampling blood, too, from earlobe (but never the fingertip) may be appropriate as a replacement for arterial PO(2), unless precision is required as the residual standard error is 6 mm Hg when predicting arterial PO(2) from an earlobe capillary sample.

Arteries↗

PubMed2006

Radiographic evidence of pulmonary edema during high-intensity interval training in women.

The purpose was to determine if an intense interval training session could produce transient pulmonary edema in women. Fourteen females [(27+/-4 years; body mass index of 21.6+/-1.5 kg/m(2)); maximal oxygen consumption = 3.12+/-0.42 L/min] performed three sets of 5 min sea-level cycling exercise with 10-min recovery between each set. Average oxygen consumption at minute 5 of each set was 96+/-5% of maximum and arterial plasma lactate concentration at minute 5 of each set was 16.0+/-3.3 mmol/L. Chest radiographs were obtained before and 33.2+/-6.1 min after exercise. Four different chest radiologists independently reviewed the radiographs for edema, and scored seven validated radiographic characteristics on a three-point scale (0-2). The overall edema score increased from 1.3+/-1.6 before exercise to 1.9+/-2.0 after exercise [P<0.05; Delta = +0.7+/-1.8, 95% CI, 0.2 to +1.1]. This study shows that an intense interval training session can cause mild, detectable pulmonary edema in some women.

Adult↗

PubMed2006

Pulmonary gas exchange does not worsen during repeat exercise in women.

The purposes were to determine (1) if repeat exercise worsens pulmonary gas exchange in women, and, (2) if the level of pulmonary edema obtained in these same women is related to the gas exchange impairment during exercise. Fourteen women (27 +/- 4 yrs; maximal oxygen uptake = 3.12 +/- 0.42 L/min) with minimal arterial PO2 (PaO2) ranging from 76 to 104 mmHg with a maximal alveolar-arterial PO2 difference (AaDO2) ranging from 7 to 35 mmHg performed three bouts of near-maximal exercise on a cycle ergometer (236 +/- 27 W) for 5 min each with 10 min of rest between sets. Cardiorespiratory parameters and oxygenation were measured at rest, throughout exercise and recovery. Chest radiographs were obtained before and 30 min after the interval training session (see Respir Physiol Neurobiol, 153 (2006) 181-190). Repeat exercise did not affect pulmonary gas exchange between sets 1 and 3 (change in PaO2 = 3 +/- 2 mmHg; change in AaDO2 = 1 +/- 2 mmHg P > 0.05). Arterial PCO2 decreased by 4 +/- 2 mmHg (P < 0.05) between sets 1 and 2, which did not reduce further in set 3. The level of PaO2 or AaDO2 was not related to the change in edema score or the post-exercise edema score (P > 0.05). In conclusion, pulmonary gas exchange is not worsened in women during interval training despite the mild edema triggered by exercise.

Adult↗

PubMed2005

Optimizing functional exercise capacity in the elderly surgical population.

PURPOSE OF REVIEW: There are several studies on the effect of exercise post surgery (rehabilitation), but few studies have looked at augmenting functional capacity prior to surgical admission (prehabilitation). A programme of prehabilitation is proposed in order to enhance functional exercise capacity in elderly patients with the intent to minimize the postoperative morbidity and accelerate postsurgical recovery. RECENT FINDINGS: Few studies have looked at exercise prehabilitation to improve functional capacity prior to surgical admission. Prehabilitation prior to orthopaedic surgery does not seem to improve quality of life or recovery. However, prehabilitation prior to abdominal or cardiac surgery, based on 275 elderly patients, results in fewer postoperative complications, shorter postoperative length of stay, improved quality of life, and reduced declines in functional disability compared to sedentary controls. SUMMARY: A concentrated 3-month progressive exercise prehabilitation programme consisting of aerobic training at 45-65% of maximal heart rate reserve (%HRR) along with periodic high-intensity interval training ( approximately 90% HRR) four times per week, 30-50 minutes per session, is recommended for improving cardiovascular functioning. A strength training programme of about 10 different exercises focused on large, multi-jointed muscle groups should also be implemented twice per week at a mean training intensity of 80% of one-repetition maximum. Finally, a minimum of 140 g ( approximately 560 kcal) of carbohydrate (CHO) should be taken 3 h before training to increase liver and muscle glycogen stores and a minimum of about 200 kcal of mixed protein-CHO should be ingested within 30 min following training to enhance muscle hypertrophy.

Activities of Daily Living↗

PubMed2005

Comparison of fingertip to arterial blood samples at rest and during exercise.

OBJECTIVE: The purpose was to determine whether arterialized fingertip blood-gas samples are comparable to arterial samples at rest and at exercise. DESIGN: Repeated measures, with subjects serving as their own controls. SETTING: Department of Anesthesia, Montreal General Hospital, Montreal, Quebec, Canada, (January to April 2004). PARTICIPANTS: Fifteen healthy men (age = 25 +/- 4 y; weight = 76.4 +/- 11.4 kg; height = 180.7 +/- 8.0 cm; peak oxygen uptake or VO2peak = 46.0 +/- 9.0 mL . kg . min). MAIN OUTCOME MEASURES: Arterial blood gases, metabolites, electrolytes. RESULTS: Blood sampled simultaneously from the radial artery and warmed fingertip at rest and during 2 levels of exercise (vigorous 181 W or 70% VO2peak; maximal 261 W or 100% VO2peak) on a electronically braked ergometer. Arterial partial pressure of oxygen in blood combining rest and the 2 exercise levels was on average 13.6 +/- 9.0 mm Hg higher than arterialized fingertip samples, with the largest difference occurring at rest (18.8 +/- 6.5 mm Hg; 95% CI = 15.5, 22.1) and the smallest difference occurring at the highest level of exercise (8.3 +/- 9.2 mm Hg; 95% CI = 3.6, 13.0; P < 0.05). The pattern for oxyhemoglobin saturation was the same, showing statistical differences between the sampling sites with the differences reduced at the highest exercise intensity. In contrast, there was no difference in arterial and arterialized partial pressure of carbon dioxide in blood (-1.0 +/- 1.5 mm Hg; 95% CI = -1.4, -0.6), or plasma lactate, glucose, pH, hemoglobin, and electrolytes between both sampling sites at rest or at the 2 exercise levels. CONCLUSION: Arterialized fingertip blood samples at rest and during exercise can predict arterial carbon dioxide pressure, and can predict arterial plasma lactate, glucose, pH, hemoglobin, and electrolytes; but not arterial oxyhemoglobin saturation or arterial oxygen pressure.

Adult↗

PubMed2004

Lung diffusion capacity for nitric oxide and carbon monoxide is impaired similarly following short-term graded exercise.

Study aimed to determine whether short-term graded exercise affects single-breath lung diffusion capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) similarly, and whether the DLNO/DLCO ratios during rest are altered post-exercise compared to pre-exercise. Eleven healthy subjects (age=29+/-6 years; weight=76.6+/-13.2 kg; height=177.9+/-13.2 cm; and maximal oxygen uptake or V(.-)(O(2max) = 52.7 +/- 9.3 ml kg(-1) min(-1))performed simultaneous single-breath DLNO and DLCO measurements at rest (inspired NO concentration=43.2+/-4.1 ppm, inspired CO concentration=0.30%) 15 min before and 2h after a graded exercise test to exhaustion (exercise duration=593+/-135 s). Resting DLNO and DLCO was similarly reduced 2h post-exercise (DLNO=-7.8+/-3.5%, DLCO=-10.3+/-6.9%, and P<0.05) due to reductions in pulmonary capillary blood volume (-11.3+/-9.0%, P<0.05) and membrane diffusing capacity for CO (-7.8+/-3.5%; P<0.05). The change in DLCO was reflected by the change in DLNO post-exercise such that 68% of the variance in the change in DLCO was accounted for by the variance in the change in DLNO (P<0.05). The DLNO/DLCO ratio was not altered post-exercise (5.87+/-0.37) compared to pre-exercise (5.70+/-0.34). We conclude that the decrease in single-breath DLNO and DLCO from pre- to post-exercise is similar, the magnitude of the change in DLCO closely reflects that of the change in DLNO, and single-breath DLNO/DLCO ratios are independent of the timing of measurement suggesting that using NO and CO transfer gases are valid in looking at short-term changes in lung diffusional conductance.

Adult↗

PubMed2004

The relationship between single-breath diffusion capacity of the lung for nitric oxide and carbon monoxide during various exercise intensities.

STUDY OBJECTIVES: To determine the relationship between single-breath diffusion capacity of the lung for nitric oxide (DLNO) and single-breath diffusion capacity of the lung for carbon monoxide (DLCO), and to determine the single-breath DLNO/DLCO ratios during rest and at several exercise intensities using a commercial lung diffusion system that uses electrochemical cells to analyze gases. SETTING AND PARTICIPANTS: Eight healthy men (age, 27 +/- 5 years; weight, 83.0 +/- 11.8 kg; height, 180.4 +/- 9.5 cm; maximal oxygen uptake [VO(2)max], 47.6 +/- 10.2 mL/kg/min [mean +/- SD]) performed single-breath DLNO measurements (inspired nitric oxide concentration, 66.5 +/- 10.6 ppm) and carbon monoxide (0.30%) randomized on different days at rest and at various exercise intensities (40%, 75%, and 90% of VO(2)max reserve [VO(2)R]) on a electrically braked load simulator. The DLCO measured on day 1 was compared to the DLCO measured during the DLNO method from another day. RESULTS: The relationship between DLNO and DLCO was linear (DLNO = 4.47 x DLCO; r(2) = 0.91; standard error of the estimate = 0.04; p < 0.05). DLNO was 4.52 +/- 0.24 times greater than DLCO, independent of exercise intensity. DLNO increased from 210.3 +/- 18.2 mL/min/mm Hg at rest to 284.2 +/- 38.6 mL/min/mm Hg at 90% VO(2)R (oxygen uptake = 42.6 +/- 9.8 mL/kg/min; 284.2 +/- 31.6 W; p < 0.05). Stepwise regression demonstrated that DLNO is predicted by alveolar volume (VA) [in liters] and workload (watts) such that DLNO = 13.4 x VA + 0.23 x workload + 107.7 (r(2) = 0.90; SEE = 17.5; p < 0.05). CONCLUSION: (1) Single-breath DLNO and DLCO increase linearly with increasing workload; (2) the single-breath DLNO/DLCO ratios are independent of exercise intensity, suggesting that using either nitric oxide or carbon monoxide as transfer gases are valid in the study of lung diffusion during any level of exercise; and (3) DLNO is mainly predicted by VA and workload.

Adult↗

PubMed2003

Acute hypervolaemia improves arterial oxygen pressure in athletes with exercise-induced hypoxaemia.

The aim of this study was to determine the effect of acute plasma volume expansion on arterial blood-gas status during 6.5 min strenuous cycling exercise comparing six athletes with and six athletes without exercise-induced arterial hypoxaemia (EIAH). We hypothesized that plasma volume expansion could improve arterial oxygen pressure in a homogeneous sample of athletes - those with EIAH. In this paper we have extended the analysis and results of our recently published surprising findings that lengthening cardiopulmonary transit time did not improve arterial blood-gas status in a heterogeneous sample of endurance cyclists. One 500 ml bag of 10 % Pentastarch (infusion condition) or 60 ml 0.9 % saline (placebo) was infused prior to exercise in a randomized, double-blind fashion on two different days. Power output, cardiac output, oxygen consumption and arterial blood gases were measured during strenuous exercise. Cardiac output and oxygen consumption were not affected by acute hypervolaemia. There were group x condition interaction effects for arterial oxygen pressure and alveolar-arterial oxygen pressure difference, suggesting that those with hypoxaemia experienced improved arterial oxygen pressure (+4 mmHg) and lower alveolar-arterial oxygen pressure difference (-2 mmHg) with infusion. In conclusion, acute hypervolaemia improves blood-gas status in athletes with EIAH. The impairment of gas exchange occurs within the first minute of exercise, and is not impaired further throughout the remaining duration of exercise. This suggests that arterial oxygen pressure is only minimally mediated by cardiac output.

Acute Disease↗

PubMed2002

Circulating white blood cells affect red cell pulmonary transit times in endurance athletes during intense exercise.

PURPOSE: The aim of this study was to determine the relationship between the right-to-left ventricular red cell pulmonary transit times (PTT) during intense exercise and circulating white blood cell (WBC) counts in highly trained endurance athletes. We postulated that high levels of WBCs preexercise would slow PTT. Eleven endurance-trained athletes (VO2max = 69.6 +/- 7.7 mL.kg-1.min-1; weight = 75.0 +/- 6.2 kg; height = 181.0 +/- 7.1 cm) performed 6.5 min constant-load, near-maximal cycling exercise (approximately 92% VO2max) on two different days. Preexercise WBC counts were measured in arterial blood drawn from the radial artery 30 min before exercise. PTT was measured during the 3rd min of exercise by first-pass radionuclide cardiography using centroid and deconvolution analysis, whereas cardiac output (Q) was measured during the last 2.5 min of exercise via a count-based ratio method from the MUGA technique. RESULTS: Combined mean PTT from both deconvolution and centroid analysis at minute three of exercise was 2.45 +/- 0.21 s, whereas the preexercise WBC count was 5.3 +/- 1.6 x 109.L-1. Cardiopulmonary blood volume at minute three of exercise was 1.22 +/- 0.13 L, VO2 was 4.58 +/- 0.44 L.min-1, and Q was 30.2 +/- 4.2 L.min-1. We found that PTT was negatively correlated with circulating WBC (r = -0.61; adjusted r2 = 0.30; P = 0.04; N = 11) but not with the dispersion (spread) of transit times around the mean (r = 0.19; P = 0.57). CONCLUSION: This suggests that athletes with higher circulating numbers of WBCs preexercise have faster (shorter) red cell transit times through the lung during intense exercise.

Cardiac Output↗