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Biomedical subjects

Juan M Murias

Publications and source records attributed to Juan M Murias.

4 recordsLinked to original sources

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↗

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↗

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↗

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↗