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A century of exercise physiology: lung fluid balance during and following exercise.
| Content Provider | Europe PMC |
|---|---|
| Author | Miserocchi, Giuseppe Beretta, Egidio |
| Abstract | PurposeThis review recalls the principles developed over a century to describe trans-capillary fluid exchanges concerning in particular the lung during exercise, a specific condition where dyspnea is a leading symptom, the question being whether this symptom simply relates to fatigue or also implies some degree of lung edema.MethodData from experimental models of lung edema are recalled aiming to: (1) describe how extravascular lung water is strictly controlled by “safety factors” in physiological conditions, (2) consider how waning of “safety factors” inevitably leads to development of lung edema, (3) correlate data from experimental models with data from exercising humans.ResultsExercise is a strong edemagenic condition as the increase in cardiac output leads to lung capillary recruitment, increase in capillary surface for fluid exchange and potential increase in capillary pressure. The physiological low microvascular permeability may be impaired by conditions causing damage to the interstitial matrix macromolecular assembly leading to alveolar edema and haemorrhage. These conditions include hypoxia, cyclic alveolar unfolding/folding during hyperventilation putting a tensile stress on septa, intensity and duration of exercise as well as inter-individual proneness to develop lung edema.ConclusionData from exercising humans showed inter-individual differences in the dispersion of the lung ventilation/perfusion ratio and increase in oxygen alveolar-capillary gradient. More recent data in humans support the hypothesis that greater vasoconstriction, pulmonary hypertension and slower kinetics of alveolar-capillary O2 equilibration relate with greater proneness to develop lung edema due higher inborn microvascular permeability possibly reflecting the morpho-functional features of the air–blood barrier.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00421-022-05066-3. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9813172&blobtype=pdf |
| ISSN | 14396319 |
| Journal | European Journal of Applied Physiology [Eur J Appl Physiol] |
| Volume Number | 123 |
| DOI | 10.1007/s00421-022-05066-3 |
| PubMed Central reference number | PMC9813172 |
| Issue Number | 1 |
| PubMed reference number | 36264327 |
| e-ISSN | 14396327 |
| Language | English |
| Publisher | Springer Berlin Heidelberg |
| Publisher Date | 2022-10-20 |
| Publisher Place | Berlin/Heidelberg |
| Access Restriction | Open |
| Rights License | Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2022 |
| Subject Keyword | Lung edema Interstitial matrix Interstitial pressure Alveolar folding/unfolding Lung diffusion Ventilation/perfusion mismatch Alveolar-capillary equilibration Precapillary vasoconstriction Pulmonary hypertension Pulmonary arterial pressure |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Physiology (medical) Public Health, Environmental and Occupational Health Sports Science |
