Excessive gas exchange impairment during exercise in a subject with a history of bronchopulmonary dysplasia and high altitude pulmonary edema.
A 27-year-old male subject (V(O2 max)), 92% predicted) with a history of bronchopulmonary dysplasia (BPD) and a clinically documented case of high altitude pulmonary edema (HAPE) was examined at rest and during exercise. Pulmonary function testing revealed a normal forced vital capacity (FVC, 98.1% predicted) and diffusion capacity for carbon monoxide (D(L(CO)), 91.2% predicted), but significant airway obstruction at rest [forced expiratory volume in 1 sec (FEV(1)), 66.5% predicted; forced expiratory flow at 50% of vital capacity (FEF(50)), 34.3% predicted; and FEV(1) /FVC 56.5%] that was not reversible with an inhaled bronchodilator. Gas exchange worsened from rest to exercise, with the alveolar to arterial P(O2) difference (AaD(O2)) increasing from 0 at rest to 41 mmHg at maximal normoxic exercise (VO(2) = 41.4 mL/kg/min) and from 11 to 31 mmHg at maximal hypoxic exercise (VO(2) = 21.9 mL/kg/min). Arterial P(O2) decreased to 67.8 and 29.9 mmHg at maximal normoxic and hypoxic exercise, respectively. These data indicate that our subject with a history of BPD is prone to a greater degree of exercise-induced arterial hypoxemia for a given VO(2) and F(I(O2)) than healthy age-matched controls, which may increase the subject's susceptibility to high altitude illness.
Lovering
Andrew T
AT
University of Wisconsin School of Medicine and Public Health, Department of Population Health Sciences, John Rankin Laboratory of Pulmonary Medicine, Madison, Wisconsin 53706-1532, USA. atlovering@wisc.edu
Romer
Lee M
LM
Haverkamp
Hans C
HC
Hokanson
John S
JS
Eldridge
Marlowe W
MW
D000328:Adult; D000532:Altitude Sickness / Q000150:complications / Q000503:physiopathology*; D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology*; D015444:Exercise; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010101:Oxygen Consumption; D011654:Pulmonary Edema / Q000150:complications / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange