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Modelling the relationships between arterial oxygen saturation, exercise intensity and the level of aerobic performance in acute hypoxia

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Abstract

Purpose

The aim of this study was to establish a model to estimate the level of arterial oxygen saturation (SpO2) and help determine the appropriate hypoxic dose in humans exercising in acute hypoxia.

Methods

SpO2 values were collected in seven untrained (UTS) and seven endurance-trained male subjects (ETS) who performed six cycle incremental and maximal tests at sea level and at simulated altitudes of 1000, 1500, 2500, 3500 and 4500 m. Oxygen uptake was continuously measured and maximal oxygen uptake (\(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\)) was determined in each subject and at each altitude. Intensity was expressed as percentage of \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\).

Results

There were strong non-linear relationships between altitude and SpO2 at low, moderate and high intensity both in ETS and UTS (r = 0.97, p < 0.001). SpO2 was significantly correlated to exercise intensity at sea level and at all simulated altitudes in ETS but only from 2500 m in UTS. There were inverse correlations between SpO2 and sea-level \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) at all altitudes, which were stronger from 2500 m and with the increase in exercise intensity. The three-variable model we established predicts (p < 0.001) the SpO2 level of individuals exercising in acute hypoxia based on their sea-level \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\), the intensity of exercise and the altitude level.

Conclusion

The model demonstrates that the drop of SpO2 during exercise in acute hypoxia is larger with the increase in both sea-level \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) and exercise intensity. The model also highlights that the pivotal altitude from which the fall in SpO2 is exacerbated is between 2000 and 2500 m, depending on both sea-level \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) and exercise intensity.

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Abbreviations

\({{\text{C}{\bar{\text{v}}}\text{O}}}_{{2}}\) :

Venous oxygen concentration

ETS:

Endurance-trained subjects

FIO2 :

Inspired oxygen fraction

LLTH:

Living low training high

O2 :

Oxygen

PO2 :

Oxygen partial pressure

SaO2 :

Arterial oxygen saturation

SpO2 :

Transcutaneous arterial oxygen saturation

UTS:

Untrained subjects

\({{\dot{\mathrm{V}}\mathrm{A}/\dot{\mathrm{Q}}}}\) :

Ventilation-to-perfusion ratio

\({\dot{\mathrm{V}}\mathrm{O}}_{{2}}\) :

Oxygen uptake

\({\dot{\mathrm{V}}\mathrm{O}}_{{{\mathrm{2max}}}}\) :

Maximal oxygen uptake

\({\dot{\mathrm{V}}\mathrm{O}}_{{{\mathrm{2max}}}} {\mathrm{SL}}\) :

Sea-level maximal oxygen uptake

References

  • Anchisi S, Moia C, Ferretti G (2001) Oxygen delivery and oxygen return in humans exercising in acute normobaric hypoxia. Pflugers Arch 442:443–450

    Article  CAS  Google Scholar 

  • Barker SJ (2002) “Motion-resistant” pulse oximetry: a comparison of new and old models. Anesth Analg 95:967–972

    Article  Google Scholar 

  • Calbet JA, Lundby C (2009) Air to muscle O2 delivery during exercise at altitude. High Alt Med Biol 10:123–134

    Article  Google Scholar 

  • Connett RJ, Honig CR, Gayeski TE, Brooks GA (1990) Defining hypoxia: a systems view of VO2, glycolysis, energetics, and intracellular PO2. J Appl Physiol 68:833–842

    Article  CAS  Google Scholar 

  • Dempsey JA, Wagner PD (1999) Exercise-induced arterial hypoxemia. J Appl Physiol 87:1997–2006

    Article  CAS  Google Scholar 

  • Dempsey JA, Hanson PG, Henderson KS (1984) Exercise-induced arterial hypoxaemia in healthy human subjects at sea level. J Physiol 355:161–175

    Article  CAS  Google Scholar 

  • Faiss R, Pialoux V, Sartori C, Faes C, Deriaz O, Millet GP (2013) Ventilation, oxidative stress, and nitric oxide in hypobaric versus normobaric hypoxia. Med Sci Sports Exerc 45:253–260

    Article  CAS  Google Scholar 

  • Ferretti G, Moia C, Thomet JM, Kayser B (1997) The decrease of maximal oxygen consumption during hypoxia in man: a mirror image of the oxygen equilibrium curve. J Physiol 498:231–237

    Article  CAS  Google Scholar 

  • Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T (2010) Effects of acute hypoxia at moderate altitude on stroke volume and cardiac output during exercise. Int Heart J 51:170–175

    Article  Google Scholar 

  • Galy O, Le Gallais D, Hue O, Boussana A, Préfaut C (2005) Is exercise-induced arterial hypoxemia in triathletes dependent on exercise modality ? Int J Sports Med 26:719–726

    Article  CAS  Google Scholar 

  • Gavin T, Stager MJ (1999) The effect of exercise modality on exercise-induced hypoxemia. Respir Physiol 115:317–323

    Article  CAS  Google Scholar 

  • Ghofrani HA, Reichenberger F, Kohstall MG, Mrosek EH, Seeger T, Olschewski H, Seeger W, Grimminger F (2004) Sildenafil increased exercise capacity during hypoxia at low altitudes and at Mount Everest base camp: a randomized, double-blind, placebo-controlled crossover trial. Ann Intern Med 141:169–177

    Article  CAS  Google Scholar 

  • Hammond MD, Gale GE, Kapitan KS, Ries A, Wagner PD (1986) Pulmonary gas exchange in humans during exercise at sea level. J Appl Physiol 60:1590–1598

    Article  CAS  Google Scholar 

  • Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P (2007) Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ 335:136

    Article  Google Scholar 

  • Hopkins SR (2006) Exercise induced arterial hypoxemia: the role of ventilation-perfusion inequality and pulmonary diffusion limitation. Adv Exp Med Biol 588:17–30

    Article  Google Scholar 

  • Kenney WL, Wilmore J, Costill DL (2015) Physiology of sport and exercise, 6th edn. Human Kinetics, Champaign, IL

    Google Scholar 

  • Laursen PB, Rhodes EC, Langill RH, Taunton JE, McKenzie DC (2005) Exercise-induced arterial hypoxemia is not different during cycling and running in triathletes. Scand J Med Sci Sports 15:113–117

    Article  Google Scholar 

  • Martin D, O’Kroy J (1993) Effects of acute hypoxia on the VO2max of trained and untrained subjects. J Sports Sci 11:37–42

    Article  CAS  Google Scholar 

  • Mollard P, Woorons X, Letournel M, Cornolo J, Lamberto C, Beaudry M, Richalet JP (2007a) Role of maximal heart rate and arterial O2 saturation on the decrement of VO2max in moderate acute hypoxia in trained and untrained men. Int J Sports Med 28:186–192

    Article  CAS  Google Scholar 

  • Mollard P, Woorons X, Letournel M, Lamberto C, Favret F, Pichon A, Beaudry M, Richalet JP (2007b) Determinants of maximal oxygen uptake in moderate acute hypoxia in endurance athletes. Eur J Appl Physiol 100:663–673

    Article  CAS  Google Scholar 

  • Mollard P, Bourdillon N, Letournel M, Herman H, Gibert S, Pichon A, Woorons X, Richalet JP (2010) Validity of arterialized earlobe blood gases at rest and exercise in normoxia and hypoxia. Respir Physiol Neurobiol 172:179–183

    Article  Google Scholar 

  • Ortiz-Prado E, Dunn JF, Vasconez J, Castillo D, Viscor G (2019) Partial pressure of oxygen in the human body: a general review. Am J Blood Res 9:1–14

    CAS  PubMed  PubMed Central  Google Scholar 

  • Peltonen JE, Tikkanen HO, Rusko HK (2001) Cardiorespiratory responses to exercise in acute hypoxia, hyperoxia and normoxia. Eur J Appl Physiol 85:82–88

    Article  CAS  Google Scholar 

  • Piiper J, Scheid P (1981) Model for capillary-alveolar equilibration with special reference to O2 uptake in hypoxia. Respir Physiol 46:193–208

    Article  CAS  Google Scholar 

  • Powers SK, Dodd S, Lawler J, Landry G, Kirtley M, McKnight T, Grinton S (1988) Incidence of exercise induced hypoxemia in elite endurance athletes at sea level. Eur J Appl Physiol Occup Physiol 58:298–302

    Article  CAS  Google Scholar 

  • Prommer N, Sottas PE, Schoch C, Schumacher YO, Schmidt W (2008) Total haemoglobin mass: a new parameter to detect blood doping? Med Sci Sports Exerc 40:2112–2118

    Article  CAS  Google Scholar 

  • Rice AJ, Scroop GC, Thornton AT, Mc Naughton NS, Rogers KJ, Chapman MJ, Greville HW, Scicchitano R, Gore CJ (2000) Arterial hypoxemia in endurance athletes is greater during running than cycling. Respir Physiol 123:235–246

    Article  CAS  Google Scholar 

  • Richalet JP, Herry JP (2016). Médecine de montagne, 5ème ed. Elsevier-Masson ed., Paris, France

  • Saltin B (1969) Physiological effects of physical conditioning. Med Sci Sports Exerc 1:50

    Article  Google Scholar 

  • Savourey G, Launay JC, Besnard Y, Guinet-Lebreton A, Alonso A, Sauvet F, Bourrilhon C (2007) Normo or hypobaric hypoxic tests: propositions for the determination of the individual susceptibility to altitude illnesses. Eur J Appl Physiol 100:193–205

    Article  Google Scholar 

  • Schmutz S, Däpp C, Wittwer M, Durieux AC, Mueller M, Weinstein F, Vogt M, Hoppeler H, Flück M (2010) A hypoxia complement differentiates the muscle response to endurance exercise. Exp Physiol 95:723–735

    Article  Google Scholar 

  • Soo J, Girard O, Ihsan M, Fairchild T (2020) The use of the SpO2 to FiO2 ratio to individualize the hypoxic dose in sport science, exercise, and health Settings. Front Physiol 11:570472

    Article  Google Scholar 

  • Sutton JR, Reeves JT, Wagner PD, Groves BM, Cymerman A, Malconian MK, Rock PB, Young PM, Walter SD, Houston CS (1988) Operation Everest II: oxygen transport during exercise at extreme simulated altitude. J Appl Physiol 64:1309–1321

    Article  CAS  Google Scholar 

  • Torre-Bueno JR, Wagner PD, Saltzman HA, Gale GE, Moon RE (1985) Diffusion limitation in normal humans during exercise at sea level and simulated altitude. J Appl Physiol 58:989–995

    Article  CAS  Google Scholar 

  • Trivedi NS, Ghouri AF, Lai E, Shah NK, Barker SJ (1997) Pulse oximeter performance during desaturation and resaturation: a comparison of seven models. J Clin Anesth 9:184–188

    Article  CAS  Google Scholar 

  • Van Thienen R, Hespel P (2016) Enhanced muscular oxygen extraction in athletes exaggerates hypoxemia during exercise in hypoxia. J Appl Physiol 120:351–361

    Article  Google Scholar 

  • Wagner PD, Gale GE, Moon RE, Torre-Bueno JR, Stolp BW, Saltzman A (1986) Pulmonary gas exchange in humans exercising at sea level and simulated altitude. J Appl Physiol 61:260–270

    Article  CAS  Google Scholar 

  • West JB (1997) Pathophysiology, 5th edn. Lippincott Williams & Wilkins, Philadelphia, PA

    Google Scholar 

  • Woorons X, Mollard P, Lamberto C, Letournel M, Richalet JP (2005) Effects of acute hypoxia on maximal exercise in trained and sedentary women. Med Sci Sports Exerc 37:147–154

    Article  Google Scholar 

  • Woorons X, Mollard P, Pichon A, Lamberto C, Duvallet A, Richalet JP (2007) Moderate exercise in hypoxia induces a greater arterial desaturation in trained than untrained men. Scand J Med Sci Sports 17:431–436

    CAS  PubMed  Google Scholar 

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Acknowledgements

The authors express their gratitude to all the participants for their great commitment

Funding

The authors declare that they received no funding for this work.

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Authors and Affiliations

  1. Univ. Lille, Univ. Artois, Univ. Littoral Côte D’Opale, EA 7369, URePSSS–Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France

    Xavier Woorons

  2. ARPEH, Association for Research and Promotion of Hypoventilation Training, 18 rue Saint Gabriel, 59800, Lille, France

    Xavier Woorons

  3. Université Sorbonne Paris Nord, INSERM 1272 Hypoxie et poumon, Bobigny, France

    Jean Paul Richalet

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  1. Xavier Woorons
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  2. Jean Paul Richalet
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Contributions

XW and JPR conceived and designed research, conducted the experiments and interpreted the results. XW wrote the manuscript. All authors have reviewed and approved the manuscript prior to submission.

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Correspondence to Xavier Woorons.

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Communicated by I. Mark Olfert.

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Woorons, X., Richalet, J.P. Modelling the relationships between arterial oxygen saturation, exercise intensity and the level of aerobic performance in acute hypoxia. Eur J Appl Physiol 121, 1993–2003 (2021). https://doi.org/10.1007/s00421-021-04667-8

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