Non-invasive ventilation applied for recovery from exercise-induced diaphragmatic fatigue.
BACKGROUND
Exercise-induced diaphragmatic fatigue (DF) is conventionally considered to reflect impaired diaphragm function resulting from load imposed on the diaphragm during exercise and is known to be reduced by the application of non-invasive ventilation (NIV) during heavy-intensity exercise testing (HEET). On that physiological condition NIV applied for diaphragm unloading during recovery from exercise should be capable of accelerating recovery from DF and therewith prolonging exercise time to exhaustion and limiting the development of DF during a subsequent HEET compared to recovery during spontaneous breathing.


METHODS
Seven highly-trained subjects (V'O(2max) 62.7±7.8 ml/kg/min) performed four HEET at 85% V'O(2max) with 60 min of recovery during I spontaneous breathing and II NIV between two HEET.


RESULTS
Twitch transdiaphragmatic pressure (TwPdi) during supramaximal magnetic phrenic nerve stimulation decreased (p<0.04) following first HEET and subsequently completely recovered (p>0.2) during I and II. Following second HEET TwPdi comparably decreased (I 0.24±0.21 vs II 0.32±0.29 kPa; p=0.17). Exercise time to exhaustion during second HEET was equal during I and II (I 514±49 vs II 511±92 s; p=0.88).


CONCLUSIONS
In conclusion, NIV applied for diaphragm unloading during recovery following HEET does neither affect recovery from DF nor subsequent exercise performance thereby providing further evidence that DF might reflect post-exercise diaphragm shielding rather than impaired diaphragm function.
Kabitz
Hans-Joachim
HJ
Department of Pneumologya, University Hospital Freiburg, Killianstrasse 5, D-79106 Freiburg, Germany. hans-joachim.kabitz@uniklinik-freiburg.de
Walker
David
D
Prettin
Stephan
S
Walterspacher
Stephan
S
Sonntag
Florian
F
Dreher
Michael
M
Windisch
Wolfram
W