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Int J Sports Med 2005; 26: S11-S18
DOI: 10.1055/s-2004-830506
© Georg Thieme Verlag KG Stuttgart · New York

Gas Exchange Measurements with High Temporal Resolution: The Breath-by-Breath Approach

K. Roecker1 , S. Prettin1 , S. Sorichter2
  • 1University of Freiburg, Medical Clinic and Polyclinic, Department of Sports Medicine (Head of Dept.: Prof. Dr. med. H.-H. Dickhuth), Freiburg, Germany
  • 2University of Freiburg, Medical Clinic and Polyclinic, Department of Pneumology (Head of Dept.: Prof. Dr. med. J. Müller-Quernheim), Freiburg, Germany
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Publikationsverlauf

Accepted after revision: October 25, 2004

Publikationsdatum:
22. Dezember 2004 (online)

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Abstract

Respiratory gas analysis as an indicator for metabolic strain during exercise has a long history. First introduced in the 18th century, huge gas collectors served for the determination of oxidative energy delivery. While still being accepted as accurate, this particular method delivers data of low temporal resolution only. Further developments of gas analysis techniques therefore focused on a higher density of data. When algorithms became available for indispensable calculations, the so-called “breath-by-breath” (BBB) method was established some decades ago. Thereby, the term BBB in the narrower sense means that a particular physiologic value is determined for each of a subject's single respiratory cycles. Reliable application of this approach depends on the performance of available computer systems, the quality of the analyzing software routines, and the responsiveness of the gas analyzers. Thus, it appears that even nowadays technical progress is continuing in this area. This review describes technical aspects and prerequisites of the BBB approach and its specific areas of application.

Key words

Respiratory gas analysis - ventilation - breathing - mass spectrometry

References

  • 1 Adachi H, Nguyen P H, Belardinelli R, Hunter D, Jung T, Wasserman K. Nitric oxide production during exercise in chronic heart failure.  Am Heart J. 1997;  134 196-202
    PubMedSuche in Google Scholar
  • 2 Aliverti A, Kayser B, Macklem P T. Breath-by-breath assessment of alveolar gas stores and exchange.  J Appl Physiol. 2004;  96 1464-1469
    CrossrefPubMedSuche in Google Scholar
  • 3 Auchincloss J H, Gilbert R, Baule G H. Effect of ventilation on oxygen transfer during early exercise.  J Appl Physiol. 1966;  21 810-818
    PubMedSuche in Google Scholar
  • 4 Barstow T J, Casaburi R, Wasserman K. O2 uptake kinetics and the O2 deficit as related to exercise intensity and blood lactate.  J Appl Physiol. 1993;  75 755-762
    CrossrefPubMedSuche in Google Scholar
  • 5 Barstow T J, Mole P A. Linear and nonlinear characteristics of oxygen uptake kinetics during heavy exercise.  J Appl Physiol. 1991;  71 2099-2106
    CrossrefPubMedSuche in Google Scholar
  • 6 Beaver W L. Water vapor corrections in oxygen consumption calculations.  J Appl Physiol. 1973;  35 928-931
    PubMedSuche in Google Scholar
  • 7 Beaver W L, Lamarra N, Wasserman K. Breath-by-breath measurement of true alveolar gas exchange.  J Appl Physiol. 1981;  51 1662-1675
    PubMedSuche in Google Scholar
  • 8 Beaver W L, Wasserman K. Transients in ventilation at start and end of exercise.  J Appl Physiol. 1968;  21 390-399
    PubMedSuche in Google Scholar
  • 9 Beaver W L, Wasserman K, Whipp B J. On-line computer analysis and breath-by-breath graphical display of exercise function tests.  J Appl Physiol. 1973;  34 128-132
    PubMedSuche in Google Scholar
  • 10 Beaver W L, Wasserman K, Whipp B J. A new method for detecting anaerobic threshold by gas exchange.  J Appl Physiol. 1986;  60 2020-2027
    CrossrefPubMedSuche in Google Scholar
  • 11 Boutellier U, Kundig T, Gomez U, Pietsch P, Koller E. Respiratory phase detection and delay determination for breath-by-breath analysis.  J Appl Physiol. 1987;  62 837-843
    PubMedSuche in Google Scholar
  • 12 Capelli C, Cautero M, di Prampero P E. New perspectives in breath-by-breath determination of alveolar gas exchange in humans.  Pflugers Arch. 2001;  441 566-577
    CrossrefPubMedSuche in Google Scholar
  • 13 Carter J, Jeukendrup A E. Validity and reliability of three commercially available breath-by-breath respiratory systems.  Eur J Appl Physiol. 2002;  86 435-441
    CrossrefPubMedSuche in Google Scholar
  • 14 Cautero M, di Prampero P E, Capelli C. New acquisitions in the assessment of breath-by-breath alveolar gas transfer in humans.  Eur J Appl Physiol. 2003;  90 231-241
    PubMedSuche in Google Scholar
  • 15 Cohen-Solal A, Aupetit J F, Gueret P, Kolsky H, Zannad F. Can anaerobic threshold be used as an end-point for therapeutic trials in heart failure? Lessons from a multicentre randomized placebo-controlled trial. The VO2 French Study Group.  Eur Heart J. 1994;  15 236-241
    PubMedSuche in Google Scholar
  • 16 Dickhuth H H, Yin L, Niess A, Roecker K, Mayer F, Heitkamp H C, Horstmann T. Ventilatory, lactate-derived and catecholamine thresholds during incremental treadmill running: relationship and reproducibility.  Int J Sports Med. 1999;  20 122-127
    Thieme ConnectPubMedSuche in Google Scholar
  • 17 Duffin J, Whitwam J G. A spirometer for breath-by-breath measurement of VE.  J Physiol. 1971;  212 7-8
    PubMedSuche in Google Scholar
  • 18 Farmery A D, Hahn C EW. Response-time enhancement of a clinical gas analyzer facilitates measurement of breath-by-breath gas exchange.  J Appl Physiol. 2000;  89 581-589
    PubMedSuche in Google Scholar
  • 19 Fowler W S. The respiratory dead space.  Am J Physiol. 1948;  154 405-416
    PubMedSuche in Google Scholar
  • 20 Fukuoka Y, Shigematsu M, Fukuba Y, Koga S, Ikegami H. Dynamics of respiratory response to sinusoidal work load in humans.  Int J Sports Med. 1997;  18 264-269
    PubMedSuche in Google Scholar
  • 21 Gaesser G A, Poole D C. The slow component of oxygen uptake kinetics in humans.  Exerc Sport Sci Rev. 1996;  24 35-71
    PubMedSuche in Google Scholar
  • 22 Gitt A K, Wasserman K, Kilkowski C, Kleemann T, Kilkowski A, Bangert M, Schneider S, Schwarz A, Senges J. Exercise anaerobic threshold and ventilatory efficiency identify heart failure patients for high risk of early death.  Circulation. 2002;  106 3079-3084
    CrossrefPubMedSuche in Google Scholar
  • 23 Grønlund J. A new method for breath-to-breath determination of oxygen flux across the alveolar membrane.  Eur J Appl Physiol Occup Physiol. 1984;  52 167-172
    PubMedSuche in Google Scholar
  • 24 Hill D W, Stephens L P, Blumoff-Ross S A, Poole D C, Smith J C. Effect of sampling strategy on measures of VO2peak obtained using commercial breath-by-breath systems.  Eur J Appl Physiol. 2003;  89 564-569
    CrossrefPubMedSuche in Google Scholar
  • 25 Hoffman G M, Torres A, Forster H V. Validation of a volumeless breath-by-breath method for measurement of respiratory quotient.  J Appl Physiol. 1993;  75 1903-1910
    PubMedSuche in Google Scholar
  • 26 Hughson R L, Northey D R, Xing H C, Dietrich B H, Cochrane J E. Alignment of ventilation and gas fraction for breath-by-breath respiratory gas exchange calculations in exercise.  Comput Biomed Res. 1991;  24 118-128
    CrossrefPubMedSuche in Google Scholar
  • 27 Johnson J S, Carlson J J, VanderLaan R L, Langholz D E. Effects of sampling interval on peak oxygen consumption in patients evaluated for heart transplantation.  Chest. 1998;  113 816-819
    CrossrefPubMedSuche in Google Scholar
  • 28 Lambertsen C J, Benjamin Jr J M. Breath-by-breath sampling of end-expiratory gas.  J Appl Physiol. 1959;  14 711-716
    PubMedSuche in Google Scholar
  • 29 Linnarsson D, Lindborg B. Breath-by-breath measurement of respiratory gas exchange using on-line analog computation.  Scand J Clin Lab Invest. 1974;  34 219-224
    PubMedSuche in Google Scholar
  • 30 Lipsky J A, Angelone A. Breath-by-breath CO2 elimination by analog computer techniques.  Med Res Eng. 1967;  6 11-15
    PubMedSuche in Google Scholar
  • 31 Lundin G. Alveolar ventilation (in normal subjects) analyzed breath by breath as nitrogen elimination during oxygen breathing.  Scand J Clin Lab Invest. 1955;  7 39-51
    PubMedSuche in Google Scholar
  • 32 Macfarlane D J. Automated metabolic gas analysis systems: a review.  Sports Med. 2001;  31 841-861
    CrossrefPubMedSuche in Google Scholar
  • 33 McArdle W D, Katch F I, Katch V L. Exercise Physiology - Energy, Nutrition and Human Performance. Philadelphia; Lea & Febiger 1986: 565
    Suche in Google Scholar
  • 34 Meyer K, Hajric R, Westbrook S, Samek L, Lehmann M, Schwaibold M, Betz P, Roskamm H. Ventilatory and lactate threshold determinations in healthy normals and cardiac patients: methodological problems.  Eur J Appl Physiol Occup Physiol. 1996;  72 387-393
    PubMedSuche in Google Scholar
  • 35 Meyer K, Westbrook S, Schwaibold M, Hajric R, Peters K, Roskamm H. Short-term reproducibility of cardiopulmonary measurements during exercise testing in patients with severe chronic heart failure.  Am Heart J. 1997;  134 20-26
    CrossrefPubMedSuche in Google Scholar
  • 36 Meyer T, Georg T, Becker C, Kindermann W. Reliability of gas exchange measurements from two different spiroergometry systems.  Int J Sports Med. 2001;  22 593-597
    Thieme ConnectPubMedSuche in Google Scholar
  • 37 Milligan D B, Wilson P F, Mautner M N, Freeman C G, McEwan M J, Clough T J, Sherlock R R. Real-time, high-resolution quantitative measurement of multiple soil gas emissions: selected ion flow tube mass spectrometry.  J Environ Qual. 2002;  31 515-524
    PubMedSuche in Google Scholar
  • 38 Myers J, Walsh D, Sullivan M, Froelicher V. Effect of sampling on variability and plateau in oxygen uptake.  J Appl Physiol. 1990;  68 404-410
    PubMedSuche in Google Scholar
  • 39 Pfitzinger P, Freedson P S. The reliability of lactate measurements during exercise.  Int J Sports Med. 1998;  19 349-357
    Thieme ConnectPubMedSuche in Google Scholar
  • 40 Phillips S M, Green H J, MacDonald M J, Hughson R L. Progressive effect of endurance training on V·O2 kinetics at the onset of submaximal exercise.  J Appl Physiol. 1995;  79 1914-1920
    PubMedSuche in Google Scholar
  • 41 Piiper J, Meyer M. Diffusion-perfusion relationships in skeletal muscle: Models and experimental evidence from inert gas washout.  Adv Exp Med Biol. 1984;  169 457-465
    PubMedSuche in Google Scholar
  • 42 Rietjens G J, Kuipers H, Kester A D, Keizer H A. Validation of a computerized metabolic measurement system (Oxycon-Pro) during low and high intensity exercise.  Int J Sports Med. 2001;  22 291-294
    Suche in Google Scholar
  • 43 Roecker K, Krieg B, Niess A, Dickhuth H H. Breath by breath measurements for the analysis of exogenous glucose oxidation during intense endurance exercise using (C-13) isotopes.  Int J Sports Med. 1996;  17 480-486
    PubMedSuche in Google Scholar
  • 44 Roecker K, Landaw E, Striegel H, Mayer F, Dickhuth H H. First-pass effect of an intravenous bolus of (13 C) bicarbonate displayed breath-by-breath.  J Appl Physiol. 2001;  90 2181-2187
    PubMedSuche in Google Scholar
  • 45 Seguin A, Lavoisier A. Premier mémoire sur la respiration des animaux. Histoire de l'Académie des sciences (1789). Dumas J Œuvres de Lavoisier. Mémoires de Chimie et de Physique. Paris; Imprimerie Impériale 1862: 688
    Suche in Google Scholar
  • 46 Sietsema K E, Cooper D M, Perloff J K, Rosove M H, Child J S, Canobbio M M, Whipp B J, Wasserman K. Dynamics of oxygen uptake during exercise in adults with cyanotic congenital heart disease.  Circulation. 1986;  73 1137-1144
    PubMedSuche in Google Scholar
  • 47 Smith D, Spanel P. The novel selected-ion flow tube approach to trace gas analysis of air and breath.  Rapid Commun Mass Spectrom. 1996;  10 1183-1198
    CrossrefPubMedSuche in Google Scholar
  • 48 Sue D Y, Hansen J E, Blais M, Wasserman K. Measurement and analysis of gas exchange during exercise using a programmable calculator.  J Appl Physiol. 1980;  49 456-461
    PubMedSuche in Google Scholar
  • 49 Sullivan M J, Cobb F R. The anaerobic threshold in chronic heart failure. Relation to blood lactate, ventilatory basis, reproducibility, and response to exercise training.  Circulation. 1990;  81 47-58
    PubMedSuche in Google Scholar
  • 50 Wasserman K, Hansen J, Sue D, Whipp B J. Principles of exercise testing and interpretation. Philadelphia; Lea & Febiger 1987
    Suche in Google Scholar
  • 51 Wasserman K, McIllroy M. Detection of anaerobic metabolism in cardiac patients during exercise.  Am J Cardiol. 1964;  14 844-852
    CrossrefPubMedSuche in Google Scholar
  • 52 Wasserman K, Whipp B J. Breath-by-breath analysis of pulmonary gas exchange and the hyperpnea of exercise under non-steady-state and steady-state conditions.  Chest. 1972;  61 46-47
    PubMedSuche in Google Scholar
  • 53 Weber K T, Janicki J S, McElroy P A. Determination of aerobic capacity and the severity of chronic cardiac and circulatory failure.  Circulation. 1987;  76 40-45
    PubMedSuche in Google Scholar
  • 54 Wessel H U, Stout R L, Bastanier C K, Paul M H. Breath-by-breath variation of FRC: effect on V·O2 and V·CO2 measured at the mouth.  J Appl Physiol. 1979;  46 1122-1126
    PubMedSuche in Google Scholar
  • 55 Weston S B, Gabbett T J. Reproducibility of ventilation of thresholds in trained cyclists during ramp cycle exercise.  J Sci Med Sport. 2001;  4 357-366
    CrossrefPubMedSuche in Google Scholar
  • 56 Whipp B J, Ward S A. Physiological determinants of pulmonary gas exchange kinetics during exercise.  Med Sci Sports Exerc. 1990;  22 62-71
    PubMedSuche in Google Scholar
  • 57 Whipp B J, Ward S A, Lamarra N, Davis J A, Wasserman K. Parameters of ventilatory and gas exchange dynamics during exercise.  J Appl Physiol. 1982;  52 1506-1513
    PubMedSuche in Google Scholar
  • 58 Yeh M P, Gardner R M, Adams T D, Yanowitz F G, Crapo R O. “Anaerobic threshold”: problems of determination and validation.  J Appl Physiol. 1983;  55 1178-1186
    PubMedSuche in Google Scholar

PD Dr. med. K. Roecker

University of Freiburg · Medical Clinic and Polyclinic · Department of Sports Medicine

Hugstetter Straße 55

79106 Freiburg

Germany

Fax: + 49 76 12 70 74 70

eMail: kai.roecker@msm1.ukl.uni-freiburg.de