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Pulmonary oedema following exercise in humans Hodges, Alastair Neil Hugh

Abstract

In order to determine if transient pulmonary oedema occurs after strenuous exercise, 10 well trained male athletes were challenged in normoxic and hypoxic conditions. To determine the minimal tolerable F₁O₂ for hypoxia, ten aerobically trained male athletes (VC^max = 57.2 ± 7.95mL-kg⁻¹•min⁻¹) performed graded cycling work to maximal effort under four conditions of varying FT02 (21%, 18%, 15%, 12%). Mean VChmax was significantly reduced while breathing 15 and 12% oxygen (VC^max = 48.2 ± 7.9 and 31.5 ± 7.4 mL-kg⁻¹•min⁻¹ respectively). In the 12% oxygen condition, the majority of the subjects were not able to complete maximal exercise without SaO"2 falling below 70%. Ten highly trained males (V02max = 65.0 ± 7.5mL- kg⁻¹•min⁻¹) then underwent assessment of lung density by quantified magnetic resonance imaging prior to and 54.0 ± 17.2 and 100.7 ± 15.1 min following 60 min of cycling exercise (61.6 ± 9.5% VO₂max). The same subjects underwent an identical measure prior to and 55.6 ± 9.8 and 104.3 ± 9.1 min following 60 min cycling exercise (65.4 ± 7.1% hypoxic VChmax) in hypoxia (F₁O₂ = 15.0%). Two subjects demonstrated mild exercise-induced arterial hypoxaemia (EIAH) (minSa0₂ = 94.5 & 93.8%), and 7 demonstrated moderate EIAH (minSa0₂ = 91.4 ± 1.1%) during a preliminary VC^max test in normoxia. No significant differences (p<0.05) were found in lung density following exercise in either condition. Mean lung densities, measured once pre- and twice post-exercise, were 0.177 ± 0.019, 0.181 ± 0.019 and 0.173 ± 0.019g•mL⁻¹ in the normoxic condition, and 0.178 ± 0.021, 0.174 ± 0.022 and 0.176 ± 0.019g•mL⁻¹ in hypoxic condition. These results indicate that transient interstitial pulmonary oedema does not occur following sustained steady-state cycling exercise in normoxia or hypoxia. This diminishes the likelihood of transient oedema as a mechanism for changes in SaO₂ during sustained exercise.

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