Proportional assist ventilation reduces the work of breathing during exercise at moderate altitude
Reducing the work of breathing (WOB) during exercise and thus the oxygen required solely for ventilation may be an option to increase the oxygen available for nonventilatory physiological tasks at altitude. This study evaluated whether pressure support ventilation (PSV) and proportional assist venti...
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Veröffentlicht in: | High altitude medicine & biology 2004-12, Vol.5 (4), p.420-428 |
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creator | Kleinsasser, Axel Von Goedecke, Achim Hoermann, Christoph Maier, Stephan Schaefer, Andreas Keller, Christian Loeckinger, Alex |
description | Reducing the work of breathing (WOB) during exercise and thus the oxygen required solely for ventilation may be an option to increase the oxygen available for nonventilatory physiological tasks at altitude. This study evaluated whether pressure support ventilation (PSV) and proportional assist ventilation (PAV) may partially reduce WOB during exercise at altitude. Seven volunteers breathing with either PSV or PAV or without support (control) were examined for WOB, inspiratory pressure time product (iPTP), and (O(2)) before and during pedaling at 160 W for 4 min on an ergometer at an altitude of 2860 m, where barometric pressure and oxygen partial pressure are approximately 30% less than at sea level. PSV and PAV reduced WOB from 4.5 +/- 0.9 J/L(-1)/min(-1) during unsupported breathing to 3.7 +/- 0.4 (p < 0.05) and 3.2 +/- 0.7 (p < 0.01), respectively. iPTP was reduced during PAV (570 +/- 151 cm H(2)O/sec/min(-1), p < 0.01), but not during PSV (727 +/- 116, p = 0.58) compared with unsupported ventilation during exercise (763 +/- 90). During PSV and PAV breathing, higher arterial oxygen saturations (84 +/- 2%, p < 0.05, and 86 +/- 1%, p < 0.01, respectively) were observed compared with control (80 +/- 3%), indicating that PSV and PAV attenuated hypoxemia during exercise at altitude. Total body (O(2)), however, was not reduced during PSV or PAV. In conclusion, both PSV and PAV reduced the WOB during exercise at altitude, but only PAV reduces iPTP. Both modes reduce hypoxemia, which may be due to higher alveolar ventilation or decreased ventilation-perfusion heterogeneity compared to unsupported breathing. |
doi_str_mv | 10.1089/ham.2004.5.420 |
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This study evaluated whether pressure support ventilation (PSV) and proportional assist ventilation (PAV) may partially reduce WOB during exercise at altitude. Seven volunteers breathing with either PSV or PAV or without support (control) were examined for WOB, inspiratory pressure time product (iPTP), and (O(2)) before and during pedaling at 160 W for 4 min on an ergometer at an altitude of 2860 m, where barometric pressure and oxygen partial pressure are approximately 30% less than at sea level. PSV and PAV reduced WOB from 4.5 +/- 0.9 J/L(-1)/min(-1) during unsupported breathing to 3.7 +/- 0.4 (p < 0.05) and 3.2 +/- 0.7 (p < 0.01), respectively. iPTP was reduced during PAV (570 +/- 151 cm H(2)O/sec/min(-1), p < 0.01), but not during PSV (727 +/- 116, p = 0.58) compared with unsupported ventilation during exercise (763 +/- 90). During PSV and PAV breathing, higher arterial oxygen saturations (84 +/- 2%, p < 0.05, and 86 +/- 1%, p < 0.01, respectively) were observed compared with control (80 +/- 3%), indicating that PSV and PAV attenuated hypoxemia during exercise at altitude. Total body (O(2)), however, was not reduced during PSV or PAV. In conclusion, both PSV and PAV reduced the WOB during exercise at altitude, but only PAV reduces iPTP. Both modes reduce hypoxemia, which may be due to higher alveolar ventilation or decreased ventilation-perfusion heterogeneity compared to unsupported breathing.</description><identifier>ISSN: 1527-0297</identifier><identifier>EISSN: 1557-8682</identifier><identifier>DOI: 10.1089/ham.2004.5.420</identifier><identifier>PMID: 15671631</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Altitude ; Analysis of Variance ; Austria ; Exercise - physiology ; Humans ; Hypoxia - etiology ; Intermittent Positive-Pressure Ventilation - methods ; Male ; Positive-Pressure Respiration - methods ; Pulmonary Gas Exchange - physiology ; Space life sciences ; Time Factors ; Work of Breathing</subject><ispartof>High altitude medicine & biology, 2004-12, Vol.5 (4), p.420-428</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-917172178e6bde6a975084725745aed8286e581c48c7eb5089c8dc7126b410703</citedby><cites>FETCH-LOGICAL-c293t-917172178e6bde6a975084725745aed8286e581c48c7eb5089c8dc7126b410703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3042,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15671631$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kleinsasser, Axel</creatorcontrib><creatorcontrib>Von Goedecke, Achim</creatorcontrib><creatorcontrib>Hoermann, Christoph</creatorcontrib><creatorcontrib>Maier, Stephan</creatorcontrib><creatorcontrib>Schaefer, Andreas</creatorcontrib><creatorcontrib>Keller, Christian</creatorcontrib><creatorcontrib>Loeckinger, Alex</creatorcontrib><title>Proportional assist ventilation reduces the work of breathing during exercise at moderate altitude</title><title>High altitude medicine & biology</title><addtitle>High Alt Med Biol</addtitle><description>Reducing the work of breathing (WOB) during exercise and thus the oxygen required solely for ventilation may be an option to increase the oxygen available for nonventilatory physiological tasks at altitude. This study evaluated whether pressure support ventilation (PSV) and proportional assist ventilation (PAV) may partially reduce WOB during exercise at altitude. Seven volunteers breathing with either PSV or PAV or without support (control) were examined for WOB, inspiratory pressure time product (iPTP), and (O(2)) before and during pedaling at 160 W for 4 min on an ergometer at an altitude of 2860 m, where barometric pressure and oxygen partial pressure are approximately 30% less than at sea level. PSV and PAV reduced WOB from 4.5 +/- 0.9 J/L(-1)/min(-1) during unsupported breathing to 3.7 +/- 0.4 (p < 0.05) and 3.2 +/- 0.7 (p < 0.01), respectively. iPTP was reduced during PAV (570 +/- 151 cm H(2)O/sec/min(-1), p < 0.01), but not during PSV (727 +/- 116, p = 0.58) compared with unsupported ventilation during exercise (763 +/- 90). During PSV and PAV breathing, higher arterial oxygen saturations (84 +/- 2%, p < 0.05, and 86 +/- 1%, p < 0.01, respectively) were observed compared with control (80 +/- 3%), indicating that PSV and PAV attenuated hypoxemia during exercise at altitude. Total body (O(2)), however, was not reduced during PSV or PAV. In conclusion, both PSV and PAV reduced the WOB during exercise at altitude, but only PAV reduces iPTP. Both modes reduce hypoxemia, which may be due to higher alveolar ventilation or decreased ventilation-perfusion heterogeneity compared to unsupported breathing.</description><subject>Adult</subject><subject>Altitude</subject><subject>Analysis of Variance</subject><subject>Austria</subject><subject>Exercise - physiology</subject><subject>Humans</subject><subject>Hypoxia - etiology</subject><subject>Intermittent Positive-Pressure Ventilation - methods</subject><subject>Male</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Pulmonary Gas Exchange - physiology</subject><subject>Space life sciences</subject><subject>Time Factors</subject><subject>Work of Breathing</subject><issn>1527-0297</issn><issn>1557-8682</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkDtPwzAURi0EoqWwMiJPbAm2Ez8yooqXhAQDzJZj31JDUhfb4fHvSdRKTN-ne8-9w0HonJKSEtVcrU1fMkLqkpc1IwdoTjmXhRKKHU6dyYKwRs7QSUrvZORUxY_RjHIhqajoHLXPMWxDzD5sTIdNSj5l_AWb7DszDXEEN1hIOK8Bf4f4gcMKtxFMXvvNG3ZDnAJ-IFqfAJuM--Agmjz2Lvs8ODhFRyvTJTjb5wK93t68LO-Lx6e7h-X1Y2FZU-WioZJKRqUC0ToQppGcqFoyLmtuwCmmBHBFba2shHbcNVY5KykTbU2JJNUCXe7-bmP4HCBl3ftkoevMBsKQtJCsEpzyESx3oI0hpQgrvY2-N_FXU6Inq3q0qiermuvR6nhwsf88tD24f3yvsfoDmyZz3g</recordid><startdate>20041201</startdate><enddate>20041201</enddate><creator>Kleinsasser, Axel</creator><creator>Von Goedecke, Achim</creator><creator>Hoermann, Christoph</creator><creator>Maier, Stephan</creator><creator>Schaefer, Andreas</creator><creator>Keller, Christian</creator><creator>Loeckinger, Alex</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041201</creationdate><title>Proportional assist ventilation reduces the work of breathing during exercise at moderate altitude</title><author>Kleinsasser, Axel ; Von Goedecke, Achim ; Hoermann, Christoph ; Maier, Stephan ; Schaefer, Andreas ; Keller, Christian ; Loeckinger, Alex</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-917172178e6bde6a975084725745aed8286e581c48c7eb5089c8dc7126b410703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Altitude</topic><topic>Analysis of Variance</topic><topic>Austria</topic><topic>Exercise - physiology</topic><topic>Humans</topic><topic>Hypoxia - etiology</topic><topic>Intermittent Positive-Pressure Ventilation - methods</topic><topic>Male</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Pulmonary Gas Exchange - physiology</topic><topic>Space life sciences</topic><topic>Time Factors</topic><topic>Work of Breathing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kleinsasser, Axel</creatorcontrib><creatorcontrib>Von Goedecke, Achim</creatorcontrib><creatorcontrib>Hoermann, Christoph</creatorcontrib><creatorcontrib>Maier, Stephan</creatorcontrib><creatorcontrib>Schaefer, Andreas</creatorcontrib><creatorcontrib>Keller, Christian</creatorcontrib><creatorcontrib>Loeckinger, Alex</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>High altitude medicine & biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kleinsasser, Axel</au><au>Von Goedecke, Achim</au><au>Hoermann, Christoph</au><au>Maier, Stephan</au><au>Schaefer, Andreas</au><au>Keller, Christian</au><au>Loeckinger, Alex</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proportional assist ventilation reduces the work of breathing during exercise at moderate altitude</atitle><jtitle>High altitude medicine & biology</jtitle><addtitle>High Alt Med Biol</addtitle><date>2004-12-01</date><risdate>2004</risdate><volume>5</volume><issue>4</issue><spage>420</spage><epage>428</epage><pages>420-428</pages><issn>1527-0297</issn><eissn>1557-8682</eissn><abstract>Reducing the work of breathing (WOB) during exercise and thus the oxygen required solely for ventilation may be an option to increase the oxygen available for nonventilatory physiological tasks at altitude. This study evaluated whether pressure support ventilation (PSV) and proportional assist ventilation (PAV) may partially reduce WOB during exercise at altitude. Seven volunteers breathing with either PSV or PAV or without support (control) were examined for WOB, inspiratory pressure time product (iPTP), and (O(2)) before and during pedaling at 160 W for 4 min on an ergometer at an altitude of 2860 m, where barometric pressure and oxygen partial pressure are approximately 30% less than at sea level. PSV and PAV reduced WOB from 4.5 +/- 0.9 J/L(-1)/min(-1) during unsupported breathing to 3.7 +/- 0.4 (p < 0.05) and 3.2 +/- 0.7 (p < 0.01), respectively. iPTP was reduced during PAV (570 +/- 151 cm H(2)O/sec/min(-1), p < 0.01), but not during PSV (727 +/- 116, p = 0.58) compared with unsupported ventilation during exercise (763 +/- 90). During PSV and PAV breathing, higher arterial oxygen saturations (84 +/- 2%, p < 0.05, and 86 +/- 1%, p < 0.01, respectively) were observed compared with control (80 +/- 3%), indicating that PSV and PAV attenuated hypoxemia during exercise at altitude. Total body (O(2)), however, was not reduced during PSV or PAV. In conclusion, both PSV and PAV reduced the WOB during exercise at altitude, but only PAV reduces iPTP. Both modes reduce hypoxemia, which may be due to higher alveolar ventilation or decreased ventilation-perfusion heterogeneity compared to unsupported breathing.</abstract><cop>United States</cop><pmid>15671631</pmid><doi>10.1089/ham.2004.5.420</doi><tpages>9</tpages></addata></record> |
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subjects | Adult Altitude Analysis of Variance Austria Exercise - physiology Humans Hypoxia - etiology Intermittent Positive-Pressure Ventilation - methods Male Positive-Pressure Respiration - methods Pulmonary Gas Exchange - physiology Space life sciences Time Factors Work of Breathing |
title | Proportional assist ventilation reduces the work of breathing during exercise at moderate altitude |
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