scholarly journals Clinical verification of vimentin/EpCAM immunolipid magnetic sorting system in monitoring CTCs in arterial and venous blood of advanced tumor

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Liu ◽  
Qiuying Li ◽  
Tingsong Chen ◽  
Tianhao Shen ◽  
Xufeng Zhang ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Venous Blood ◽  
Gene Mutations ◽  
Dominant Factor ◽  
Positive Group ◽  
Arterial Blood ◽  
Significant Difference ◽  
Targeted Drug ◽  
Sorting System ◽  
Advanced Tumors

Abstract Background Circulating tumor cells (CTCs) are the dominant factor leading to tumor metastasis. This study aims to investigate the effect of disparate sources of CTCs on the treatment and prognosis of patients with advanced tumors by analyzing the number and gene mutations change of CTCs in arterial and venous blood in patients with advanced tumors. Results A CTCs sorting system was constructed based on Vimentin-immunolipid magnetic balls (Vi-IMB) and EpCAM immunolipid magnetic balls (Ep-IMB). Results showed that the prepared Ep-IMB and Vi-IMB had lower cytotoxicity, better specificity and sensitivity. The number of arterial CTCs was higher than that of venous CTCs, with a statistically significant difference (P < 0.05). Moreover, the prognosis of the low positive group of total CTCs in arterial blood and venous blood was higher than that of the high positive group, with a statistical significance (P < 0.05). The genetic testing results showed that the targeted drug gene mutations in tissues, arterial CTCs and venous CTCs showed a complementary trend, indicating that there was heterogeneity among different tumor samples. Conclusions CTCs in blood can be efficiently captured by the CTCs sorting system based on Vi-LMB/Ep-LMB, and CTCs detection in arterial blood can be utilized to more accurately evaluate the prognosis and predict postoperative progress. It is further confirmed that tumor samples from disparate sources are heterogeneous, providing a reference basis for gene mutation detection before clinical targeted drug treatment, and the detection of CTCs in arterial blood has more potential clinical application value. Trial registration: The Ethics Committee of Putuo Hospital, PTEC-A-2019-18-1. Registered 24 September 2019. Graphic abstract

Carbon Dioxide Equilibration in Canine Lungs during Rebreathing and Acute Alkalosis

1979 ◽  
Vol 57 (5) ◽  
pp. 385-388 ◽  
Author(s):  
R. D. Latimer ◽  
G. Laszlo
Keyword(s):  
Whole Blood ◽  
Base Excess ◽  
Venous Blood ◽  
Main Pulmonary Artery ◽  
Mixed Venous Blood ◽  
Arterial Blood ◽  
Significant Difference ◽  
Venous Pco2 ◽  
Pulmonary Arterial ◽  
Gas Pressures

1. The left lower lobe of the lungs of six anaesthetized dogs were isolated by the introduction of a bronchial cannula at thoracotomy. Catheters were introduced into the main pulmonary artery and a vein draining the isolated lobe. 2. Blood-gas pressures and pH were measured across the isolated lobe and compared with gas pressures in alveolar samples from the lobe. 3. When the isolated lobe was allowed to reach gaseous equilibrium with pulmonary arterial blood for 30 min, there was no significant difference between alveolar and pulmonary venous Pco2. Mean values of whole-blood base excess were similar in pulmonary arterial and pulmonary venous blood. 4. After injection of 20 ml of 8·4% sodium bicarbonate solution into a peripheral vein, Pco2, pH and plasma bicarbonate concentrations rose in the mixed venous blood. There was no change of whole-blood base excess across the lung, indicating that HCO−3, as distinct from dissolved CO2, did not enter lung tissue in measurable amounts. 5. No systematic alveolar—pulmonary venous Pco2 differences were demonstrated in this preparation other than those explicable by maldistribution of lobar blood flow.

Cardio-respiratory and biochemical responses of military training event at Jungle environment

2021 ◽  
Vol 12 (4) ◽  
pp. 15-23
Author(s):  
Angad Yadav ◽  
Tirthankar Chatterjee ◽  
Debojyoti Bhattacharyya ◽  
Somnath Singh ◽  
Madhusudan Pal
Keyword(s):  
Core Body Temperature ◽  
Statistical Significance ◽  
Military Training ◽  
Venous Blood ◽  
Post Exercise ◽  
Biochemical Responses ◽  
Significant Difference ◽  
Training Event ◽  
Training Activities ◽  
Exercise Induced

Background: In military environment, soldiers regularly practice or undergo different types of extreme training activities. However, globally the literatures available on the physiological and biochemical demand of different extreme military training activities are very scanty and less reported. Aims and Objective: The present study was undertaken to quantify the cardio-respiratory and biochemical responses of military training event in jungle environment. Materials and Methods: Mathew’s Mad Mile (MMM) activity is a type of specialized run of 1.5 mile in jungle environment. This training activity was conducted on rugged jungle terrain comprised of undulated uphill, downhill, muddy surface. Twenty-five SHAPE-1 healthy soldiers were volunteered into training event. Cardiorespiratory data was recorded continuously throughout the event and venous blood sample was drawn before and immediately after completion of the event. Statistical significance was considered at p<0.05. Results: There was no significant difference observed in heart rate and breathing rate while core body temperature was significantly (p = 0.02) higher in slow finisher as compared to fast finisher. In fast finisher, post exercise level of BDNF, BNP, SDH, cortisol and UCP1 increased significantly (p<0.05), whereas, BHB (p<0.01) decreased significantly in comparison to pre-exercise. In slow finishers, post exercise level of cortisol, KYNA and UCP1 increased significantly (p<0.05), whereas, BDNF, BNP and SDH decreased significantly (p<0.05), in comparison to pre-exercise. Conclusion: The outcome of this study indicated that the slow finishers were more susceptible to risk of injury due to higher exercise induced thermogenesis and mental stress in comparison to fast finisher.

scholarly journals High preanalytical non-compliance and samples rejection rate in clinical biochemistry laboratory are decreased by nurse staff training in phlebotomy and sample handling

2020 ◽  
Vol 13 (3) ◽  
pp. 113-118
Author(s):  
Modibo Coulibaly ◽  
Abdelaye Keita ◽  
Moussa Diawara ◽  
Valentin Sagara ◽  
Brehima Traoré ◽  
...  
Keyword(s):  
Staff Training ◽  
Clinical Biochemistry ◽  
Statistical Significance ◽  
Venous Blood ◽  
Diagnostic Errors ◽  
Hospital Staff ◽  
Clinical Samples ◽  
Sample Handling ◽  
Significant Difference ◽  
Clinical Biochemistry Laboratory

Background: Preanalytical phase of biomedical analysis remains an important source of diagnostic errors that deserves special attention. This study aims to evaluate the training in phlebotomy and sample handling impact on the preanalytical non-compliances. Material and Methods: we performed a prospective study before and after staff training in phlebotomy and sample handling by systematically recording all clinical samples non-compliances. First, we assessed and describe the non-compliance baseline rate from January to December 2017 in the clinical biochemistry laboratory of Hôpital Sominé DOLO de Mopti. After two sessions of one week staff training in January 2018, we performed the same study from January to December 2018. We compared the proportions of non-compliances between the two assessments. Data were collected on the case report forms, captured in Excel and analyzed by R software for (Mac) OS X version 4.0.3. Pearson Ch2 or Fisher exact tests were used for the comparison of proportions. The statistical significance was set at p < 5%. Results: a total of 27,810 venous blood samples were received during the study period; 48% was for biochemistry, 41% for immuno-serology, 9% for blood cell count and 2% for coagulation tests. There were 3,826 instances of preanalytical non-compliances (13.76%) identified that led to sample rejection. Out of the 11 types of non-compliances investigated, 5 (45.4%) accounted for nearly 91% of the problems: insufficient sample volume (28.9%), hemolyzed samples (20.5%), inappropriate collection time (17.8%), sample clot (12.9%), and inappropriate sample collection tube (10.8%). We observed a significant difference in rates of non-compliance between inpatients and outpatients samples (44.4% vs 7.3%; p < 0.001). The proportion of non-compliance have significatively decreased after the two training sessions of hospital staff in phlebotomy and sample handling 3,826/27,810 (13.8%) vs 3,009/32,476 (9.3%); p < 0.001. Conclusion: we report a significantly higher rate of non-compliance in inpatients. Hospital staff training in phlebotomy and sample handling reduce the proportion of preanalytical non-compliance and thereby improve patient management and safety.

scholarly journals Clinical and neurophysiological findings in oligoclonal band negative multiple sclerosis patients

2003 ◽  
Vol 131 (3-4) ◽  
pp. 122-126 ◽  
Author(s):  
Sarlota Mesaros ◽  
Jelena Drulovic ◽  
Zvonimir Levic
Keyword(s):  
Multiple Sclerosis ◽  
Statistical Significance ◽  
Progression Rate ◽  
Positive Group ◽  
Clinical Difference ◽  
Initial Symptoms ◽  
Significant Difference ◽  
Intrathecal Igg Synthesis ◽  
Edss Score ◽  
Multiple Sclerosis Patients

Besides magnetic resonance imaging, the presence of locally produced oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) is the most consistent laboratory abnormality in patients with multiple sclerosis (MS). The most sensitive method for the detection of CSF OCB is isoelectric focusing (IEF) [6]. Occasional patients with clinically definite MS lack evidence for intrathecal IgG synthesis [7, 8]. This study was designed to compare clinical data and evoked potential (EP) findings between CSF OCB positive and OCB negative MS patients. The study comprised 22 OCB negative patients with clinically definite MS [11] and 22 OCB positive controls matched for age, disease duration, activity and course of MS. In both groups clinical assessment was performed by using Expanded Disability Status Scale (EDSS) score [12] and progression rate (PR). All patients underwent multimodal EP: visual (VEPs), brainstem auditory (BAEPs) and median somatosensory (mSEPs). The VEPa were considered abnormal if the P100 latency exceeded 117 ms or inter-ocular difference greater than 8 ms was detected. The BAEPs were considered abnormal if waves III or V were absent or the interpeak latencies I-III, III-V, or I-V were increased. The mSEPs were considerd abnormal when N9, N13 and N20 potentials were absent or when increased interpeak latencies were recorded. The severity of the neurophysiological abnormalities was scored for each modality as follows normal EP score 0; every other EP abnormality except the absence of one of the main waves, score 1; absence of one or more of the main waves, score 2 [13]. Both mean EDSS score (4.0 vs. 3.5) and PR (0.6 vs. 0.5) were similar in OCB positive and OCB negative group, (p>0.05). In the first group males were predominant, but without statistical significance (Table 1). Disease started more often with the brainstem symptoms in the OCB positive than in OCB negative MS group (p=0.028), while there was no differences in other initial symptoms between the groups (Graph 2). The frequency of (multimodal) EP abnormalities was higher in the OCB positive group but the differences were not statistically significant, except for bilateral SEP abnormalities (p=0.012). The severity of the AEPs abnormalities was similar in both groups while for the VEPs and SEPs abnormalities were more pronounced in the OCB positive group but not significantly (Table 2). The male preponderance of OCB negative MS patients in our study is in accordance with previous studies [14, 15]. This finding could be potentially ascribed to the well known gender-related differences in both humoral and cellular immune responses [17]. We found no statistically significant differences in either disability or PR between the two patient groups, although OCB negative MS patients had lower EDSS score and PR than OCB positive cases. In accordance with these findings, Fukazawa et al. also failed to show differences in disability between OCB negative and positive MS patients. On the other hand, few studies reported that OCB negative MS patients have a better prognosis [16 18]. The only clinical difference between two groups of patients that we found was that the disease more often started with brainstem symptoms in OCB positive MS patients (p=0.028). OCB positive MS patients had more often bilateral SEPs abnormalities (p=0.012). There was no statistically significant differences between two groups of patients in the severity of trimodal EPs abnormalities and the frequency of BAEPs and VEPs abnormalities although OCB negative patients had trend towards less pronounced EP disturbancies. In conclusion, our results did not reveal significant difference in clinical and neurophysiological(y) parameters between two groups of patients. However, they indicate a trend towards better prognosis of the disease in OCB negative MS patients.

scholarly journals Investigation of the effect of supramaximal eccentric contractions on muscle damage and recovery between the dominant and non-dominant arm

2019 ◽  
Vol 23 (6) ◽  
pp. 306-312
Author(s):  
A. Yapıcı ◽  
H.B. Yalçın
Keyword(s):  
Muscle Damage ◽  
Male Volunteer ◽  
Statistical Significance ◽  
Venous Blood ◽  
Training Data ◽  
Eccentric Contractions ◽  
Significant Statistical Difference ◽  
Research Material ◽  
Significant Difference ◽  
The Right

Purpose: This research aimed to examine the effects of supramaximal eccentric contractions on the damage of muscle and recovery between the dominant and non-dominant arm. The study was participated by ten male volunteer students who do not have any musculoskeletal and metabolic compliant. This research designed as a cross-over type research. Material: Venous blood samples were drawn before the bout, immediately after the bout one min., moreover, at the 6th, 24th, 48th, and 72nd hours after training. Data were analyzed using the SPSS 21.0 statistical software package. After exercise, the non-parametric Wilcoxon Signed Ranks Test was used to decide the dominant and non-dominant arm influence. Statistical significance for all analyses was accepted at p< 0,05. Results: There was a significant statistical difference in the right, and left arm Creatine Kinase (CK) values at the time when exercise start, 48th and 72nd hours (p<0,05). There was no statistically significant difference in right and left arm Lactate Dehydrogenase values after exercise (p>0,05). Conclusions: There was an increase in muscle damage at 24th and 48th hours after supramaximal eccentric exercise, and it was turned back the start level at 72nd hours. While the arm which is non-dominant recovery is faster than the dominant arm.

scholarly journals Time-dependent variation of ionized calcium in serum samples

2019 ◽  
Vol 29 (3) ◽  
pp. 570-578 ◽  
Author(s):  
Antonija Perović ◽  
Marina Njire Bratičević
Keyword(s):  
Clinical Significance ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Time Dependent ◽  
Ionized Calcium ◽  
Anova Analysis ◽  
Serum Samples ◽  
Arterial Blood ◽  
Significant Difference ◽  
Clinically Significant

Introduction: The aim of this study was to compare ionized calcium (iCa) concentrations in arterial heparinized blood and venous serum and to investigate time-dependent variation of iCa in serum samples centrifuged and analysed at different times. Materials and methods: Ionized calcium was measured (N = 25) in arterial blood within 20 min after puncture, and in serum within 10 min after centrifugation conducted 30 min after sampling. Effect of time between sampling and centrifugation was examined in three tubes (N = 30) centrifuged 15, 30 and 60 min after sampling, and analysed within 10 min. Effect of time between centrifugation and analysis was investigated in three tubes (N = 31) centrifuged 30 min after sampling and analysed: 0-10, 30-40 and 90-100 min after centrifugation. Ionized calcium was measured on the Siemens RapidLab 348EX analysers. Statistical significance was tested using Wilcoxon test and ANOVA analysis. Clinical significance was judged against reference change values (RCV). Results: No statistically significant difference was found between iCa in arterial blood and serum (P = 0.274). A statistically significant decrease was found: in tubes centrifuged 60 and 15 min after sampling versus 30 min (P = 0.005, P = 0.003); and in tubes analysed 30-40 and 90-100 min after centrifugation versus 0-10 min (P = 0.021, P = 0.027). Clinically significant changes were observed: 60 versus 30 min (centrifugation) and 90-100 versus 0-10 and 30-40 min (analysis). Conclusions: Timely analysed arterial blood and serum samples can be used interchangeably. To avoid clinically significant variations, serum tubes should be centrifuged within 30 min after sampling, and analysis should be performed within 30 min after centrifugation.

A METHOD TO STUDY TEMPORAL CHANGES IN ADRENAL ACTIVITY IN RELATION TO SEXUAL STATUS IN THE FEMALE LABORATORY RAT

1978 ◽  
Vol 77 (3) ◽  
pp. 283-291 ◽  
Author(s):  
J. G. PHILLIPS ◽  
W. POOLSANGUAN
Keyword(s):  
Venous Blood ◽  
Secretory Activity ◽  
Oestrous Cycle ◽  
Ovariectomized Rats ◽  
Arterial Blood ◽  
Significant Difference ◽  
Pattern Of Variation ◽  
Peripheral Arterial ◽  
High Level ◽  
Venous Plasma

There is a temporal relationship between the secretory activity of the rat adrenal gland and the stage of the oestrous cycle. In previous studies, adrenal venous blood has been sampled, but because of the stress of a lengthy operation, the gland is subjected to maximum stimulation. A new surgical approach has been developed in which samples of adrenal venous blood are taken within 3 min of contact. A competitive binding radioassay was used to determine the level of corticosterone in samples of plasma of both adrenal venous and peripheral arterial origin obtained before (3 min) and after (15 min) the onset of (presumably) ACTH-induced secretion. A reassessment of adrenal function indicated that adrenal activity peaked in pro-oestrus with higher values in the afternoon than the morning and both values were significantly higher than at any other stage in the oestrous cycle. The variations in the concentration of corticosterone in adrenal venous plasma were reflected by a similar pattern of variation in the level of corticosterone in peripheral arterial plasma. In samples of adrenal venous plasma obtained at 15 min, the level of corticosterone was approximately 25 times higher than the basal value during pro-oestrus and approximately 140 times higher than the values during the other stages of the cycle; for peripheral arterial blood the values were eight and 22–30 times higher respectively, without any significant difference when samples of either type of blood were obtained under stress. This indicates maximum stimulation by endogenous ACTH. Results obtained after treatment of ovariectomized rats with progesterone and/or oestradiol and the fact that LH, but not ACTH, plays a stimulatory role in the non-stressed metoestrous animal, suggest that the peak of adrenal activity at the time of pro-oestrus might be biphasic: in the morning it is influenced by a high level of oestrogen and a low level of progesterone; in the afternoon this balance is reversed. The effect is secondary to the surge of LH which may have a direct effect on the peak of adrenal activity at this critical period.

Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial

2020 ◽  
pp. 1098612X2096275
Author(s):  
Gabriela P Costa ◽  
Eduardo R Monteiro ◽  
Éder J Marques ◽  
Rafael C Beck ◽  
Rafael K Carneiro ◽  
...  
Keyword(s):  
Venous Blood ◽  
Blood Gases ◽  
Systolic Arterial Pressure ◽  
Reference Intervals ◽  
Arterial Blood ◽  
Main Adverse Effect ◽  
Significant Difference ◽  
Sedative Effects ◽  
Sedation Scores ◽  
Descriptive Scale

Objectives The aim of this study was to compare the sedative effects in cats administered acepromazine–nalbuphine and acepromazine–butorphanol, intramuscularly (IM) and intravenously (IV), and the occurrence of adverse cardiorespiratory effects. Methods Forty-six cats were randomly divided into four groups and administered acepromazine (0.05 mg/kg) combined with nalbuphine (0.5 mg/kg) or butorphanol (0.4 mg/kg), IV (ACP-NALIV and ACP-BUTIV groups, respectively) or IM (ACP-NALIM and ACP-BUTIM groups, respectively). Sedation scores, ease of intravenous catheter placement (simple descriptive scale [SDS] scores), physiologic variables, venous blood gases and the propofol dose required for anesthetic induction were recorded. Results Mild sedation was observed in all groups approximately 30 mins after treatment administration (timepoint T1, prior to propofol administration). Sedation scores at T1 increased above baseline in all groups ( P <0.05), but no significant difference was observed among groups. Dynamic interactive visual analogue scale sedation scores (range 0–100 mm) recorded at T1 were (median [interquartile range]): ACP-NALIM, 12 (10–12); ACP-NALIV, 11 (6–16); ACP-BUTIM, 11 (7–14); and ACP-BUTIV, 12 (7–19). Overall, SDS scores did not change from baseline at T1 and there was no significant difference among groups. The propofol dose did not differ among groups. Blood gases remained within the reference intervals for cats. Significant decreases from baseline were detected for all groups in systolic arterial pressure (SAP). Mean ± SD values at T1 were (mmHg): ACP-NALIM, 108 ± 13; ACP-NALIV, 102 ± 10; ACP-BUTIM, 97 ± 13; and ACP-BUTIV, 98 ± 21. Arterial hypotension (SAP <90 mmHg) was recorded at T1 in 0/11, 1/13, 4/11 and 5/11 cats in groups ACP-NALIM, ACP-NALIV, ACP-BUTIM and ACP-BUTIV, respectively, and was further exacerbated after the induction of anesthesia with propofol. Conclusions and relevance In healthy cats administered acepromazine–nalbuphine and acepromazine–butorphanol, IM and IV, the degree of sedation was mild regardless of the protocol and the route of administration. The main adverse effect observed was a reduction in arterial blood pressure.

scholarly journals Gene mutational analysis by NGS and its clinical significance in patients with myelodysplastic syndrome and acute myeloid leukemia

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jifeng Yu ◽  
Yingmei Li ◽  
Tao Li ◽  
Yafei Li ◽  
Haizhou Xing ◽  
...  
Keyword(s):  
Gene Mutation ◽  
Induction Chemotherapy ◽  
Lower Incidence ◽  
Mutational Analysis ◽  
Statistical Significance ◽  
Age Groups ◽  
Gene Mutations ◽  
Related Gene ◽  
Significant Difference ◽  
The Individual

Abstract Background In this study, we retrospectively summarized the differences of molecular gene mutations between MDS and AML patients, as well as the young and older age groups of MDS and AML patients. We also analyzed the response of newly diagnosed AML patients to standard DA or IA induction chemotherapy and the relationship between the chemotherapy outcome and the frequency of different gene mutation abnormalities. Methods NGS assay covering 43 genes was studied in 93 de novo MDS and 325 non-M3 AML patients. Bone marrow samples from all patients underwent gene mutational analysis by NGS. Results At least one non-synonymous gene mutation was detected in 279 AML patients (85.8%) and 85 MDS patients (91.4%). Contrary to 59 years and younger AML patients, there was a significantly higher incidence of gene mutation in 60 years and older AML patients (2.37 vs 1.94, p = 0.034). Gene mutation incidence in 60 years and older MDS patients increased, but no statistical significance was present (1.95 vs 1.64, p = 0.216). AML patients had a significantly higher gene mutation incidence compared with MDS-MLD patients (2.02 vs 1.63, p = 0.046). Gene mutation incidence was higher in patients with MDS-EB1/EB2 compared with patients with MDS-MLD but there was no statistical significance present (2.14 vs 1.63, p = 0.081). AML patients had significantly higher incidences of CEBPA, FLT3-ITD, DNMT3A, NPM1 and IDH1/2 gene mutations (p = 0.0043, 0.000, 0.030962, 0.002752, and 0.000628, respectively) and a lower incidence of TET2 and U2AF1 gene mutations (p = 0.000004 and 0.000, respectively) compared with MDS patients. Among the individual genes in different age groups, there were significantly higher incidences of RUNX1, IDH2, TP53 and SF3B1 gene mutations (p = 0.0478, 0.0028, 0.0024 and 0.005, respectively) as well as a trend of higher ASXL gene mutation (p = 0.057) in 60 years and older AML patients compared to 59 years and younger patients. There was no statistically significant difference in MDS patients with the different age groups and among the individual genes. Between AML patients and MDS patients among the different gene functional groups, AML patients had a significantly higher incidence of transcriptional deregulation (27.4% vs 15.1%, p = 0.014963), activated signalling (36.3% vs 10.8%, p = 0.000002) related gene mutations as well as a significantly lower incidence of RNA spliceosome (6.15% vs 60.1%, p = 0.000) related gene mutations. Furthermore, among the patients who received either IA or DA regimen for induction chemotherapy, patients with IA regimen had a significantly better CR rate than those with DA regimen (76.6% vs 57.1%, p = 0.0228). Conclusions Different gene mutations had been found in majority of MDS and AML patients. MDS and AML patients had different gene mutation patterns. AML patients with fewer or no gene mutations had a better chance of achieving CR when treated with IA and DA regimen induction chemotherapy.

Exercise performance following a carbohydrate load in chronic airflow obstruction

1985 ◽  
Vol 58 (4) ◽  
pp. 1340-1346 ◽  
Author(s):  
S. E. Brown ◽  
S. Wiener ◽  
R. A. Brown ◽  
P. A. Marcarelli ◽  
R. W. Light
Keyword(s):  
Partial Pressure ◽  
Power Output ◽  
Venous Blood ◽  
Airflow Obstruction ◽  
Maximum Power ◽  
Arterial Partial Pressure ◽  
Maximum Power Output ◽  
Arterial Blood ◽  
Significant Difference ◽  
Ergometer Exercise

We evaluated the effects of a large (920 cal) liquid carbohydrate (CHO) load on the maximum exercise capacity of 18 patients with chronic airflow obstruction [forced expiratory volume at at 1 s (FEV1) = 1.27 +/- 0.48 liters; FEV1/forced vital capacity = 0.41 +/- 0.11]. Patients underwent duplicate incremental cycle ergometer exercise tests to a symptom-limited maximum following CHO and a liquid placebo in single-blind fashion. Expired gas measurements were obtained during each power output. In 12 patients arterial blood gases were measured, and in six patients venous blood was obtained for measurement of glucose, electrolytes, and osmolality. With CHO, the maximum power output decreased from 86 +/- 30 to 76 +/- 31 W (P less than 0.001), whereas the ventilation at exhaustion was nearly identical (47.6 +/- 13.2 and 46.8 +/- 12.5 l/min). Arterial partial pressure of CO2 (PaCO2) at exhaustion decreased (P less than 0.025), arterial partial pressure of O2 (PaO2) increased (P less than 0.01), and the ventilatory equivalent for CO2 (VE/VCO2) increased (P less than 0.005) with CHO. At equivalent power outputs, CHO resulted in significant increases in VE (P less than 0.001) and VCO2 (P less than 0.001); PaCO2 was unchanged, whereas PaO2 increased (P less than 0.01). CHO increased the serum glucose at rest and during exercise. No changes in serum osmolality or electrolytes occurred during exercise following CHO. After CHO loading, the majority of patients appeared to reach their limiting level of ventilation at a lower power output. In contrast, there was no significant difference in the mean maximum power output with CHO in six normal control subjects.

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