Breath-by-breath assessment of alveolar gas stores and exchange

Abstract

The volume of O(2) exchanged at the mouth during a breath (Vo(2,m)) is equal to that taken up by pulmonary capillaries (Vo(2,A)) only if lung O(2) stores are constant. The latter change if either end-expiratory lung volume (EELV), or alveolar O(2) fraction (Fa(O(2))) change. Measuring this requires breath-by-breath (BbB) measurement of absolute EELV, for which we used optoelectronic plethysmography combined with measurement of O(2) fraction at the mouth to measure Vo(2,A) = Vo(2,m) - (DeltaEELV x Fa(O(2)) + EELV x DeltaFa(O(2))), and divided by respiratory cycle time to obtain BbB O(2) consumption (Vo(2)) in seven healthy men during incremental exercise and recovery. To synchronize O(2) and volume signals, we measured gas transit time from mouthpiece to O(2) meter and compared Vo(2) measured during steady-state exercise by using expired gas collection with the mean BbB measurement over the same time period. In one subject, we adjusted the instrumental response time by 20-ms increments to maximize the agreement between the two Vo(2) measurements. We then applied the same total time delay (transit time plus instrumental delay = 660 ms) to all other subjects. The comparison of pooled data from all subjects revealed r(2) = 0.990, percent error = 0.039 +/- 1.61 SE, and slope = 1.02 +/- 0.015 (SE). During recovery, increases in EELV introduced systematic errors in Vo(2) if measured without taking DeltaEELV x Ca(O(2))+EELV x DeltaFa(O(2)) into account. We conclude that optoelectronic plethysmography can be used to measure BbB Vo(2) accurately when studying BbB gas exchange in conditions when EELV changes, as during on- and off-transients.