Relationship of peak capillary blood lactate accumulation and body composition in determining the mechanical energy equivalent of lactate during sprint cycling.

AIM: A 15-s all-out sprint cycle test (i.e., νLamax-test) and the post-exercise change in capillary blood lactate concentration is an emerging diagnostic tool that is used to quantify the maximal glycolytic rate. The goal of this study was to determine the relation between 15 s-work, change in capillary blood lactate concentration (∆La) and body composition in a νLamax-test. METHOD: Fifty cyclists performed a 15 s all-out sprint test on a Cyclus2 ergometer twice after a previous familiarization trial. Capillary blood was sampled before and every minute (for 8 min) after the sprint to determine ∆La. Body composition was determined employing InBody720 eight-electrode impedance analysis. RESULT: Simple regression models of fat-free mass (FFM) and also the product of FFM and ∆La showed similar ability to predict 15 s-work (R2 = 0.79; 0.82). Multiple regression combining both predictors explains 93% of variance between individuals. No differences between males and females were found regarding 15 s-work relative to the product of fat-free mass and ∆La. Considering pairs of similar FFM, a change 1 mmol/l of ∆La is estimated to be equal to 12 J/kg in 15 s-work (R2 = 0.85). DISCUSSION: Fifteen s-work is both closely related to FFM and also the product of ∆La and lactate-distribution space approximated by FFM. Differences in 15 s-work between males and females disappear when total lactate production is considered. Considering interindividual differences, the mechanical energy equivalent of blood lactate accumulation seems a robust parameter displaying a clear relationship between ∆La and 15 s-work relative to FFM.

Extracorporeal circulation during on-pump cardiac surgery: An evaluation of the energy equivalent pressure index based on waveforms decomposition in harmonics.

The use of pulsatile perfusion instead of nonpulsatile perfusion during cardiopulmonary bypass continues to be a source of debate. The disagreements among the conclusions of the published studies may be due to different factors: differences in the type of patients included in the studies, differences in the protocol of the studies, and difficulty to quantify the pulsatility of the flow. In the present paper, we propose a quantitative evaluation of Shepard's energy equivalent pressure index, based on the harmonic decomposition of the physiological aortic pressure and flow rate signal. It is thus demonstrated that the surplus energy provided by pulsatile flow remains moderate (of order 10 mm Hg), but that it can be improved by changing the relative shapes of the pressure and flow waves.

Microvascular fluid exchange during pulsatile cardiopulmonary bypass perfusion with the combined use of a nonpulsatile pump and intra-aortic balloon pump.

OBJECTIVE: To evaluate how pulsed versus nonpulsed cardiopulmonary bypass influences microvascular fluid exchange in an experimental setup combining a nonpulsatile perfusion pump and an intra-aortic balloon pump. METHODS: A total of 16 pigs were randomized to pulsatile cardiopulmonary bypass perfusion with an intra-aortic balloon pump switched to an automatic 80 beats/min mode after the start of cardiopulmonary bypass (pulsatile perfusion [PP] group, n = 8) or to nonpulsatile cardiopulmonary bypass with the pump switched to the off position (nonpulsatile [NP] group, n = 8). Normothermic cardiopulmonary bypass was initiated after 60 minutes of stabilization and continued for 3 hours. The fluid needs, plasma volume, colloid osmotic pressure in plasma, colloid osmotic pressure in interstitial fluid, hematocrit, and total tissue water content were recorded, and the protein masses and fluid extravasation rates were calculated. RESULTS: After cardiopulmonary bypass was started, the mean arterial pressure increased in the PP group and decreased in the NP group. At 180 minutes, the mean arterial pressure of the PP and NP groups was 70.9 ± 2.7 mm Hg and 55.9 ± 2.7 mm Hg, respectively (P = .004). The central venous pressure (right atrium) had decreased in the NP group (P = .002). A decreasing trend was seen in the PP group. No between-group differences were present. The hematocrit and colloid osmotic pressure in plasma and interstitial fluid had decreased similarly in both study groups during cardiopulmonary bypass. The plasma volume of the PP group had decreased initially but then returned gradually to precardiopulmonary bypass levels. In the NP group, the plasma volume remained contracted (P = .02). No significant differences in the fluid extravasation rate were obtained. The fluid extravasation rate of the PP group tended to stay slightly higher than the fluid extravasation rate of the NP group at all measurement intervals. The total tissue water content increased significantly in a number of organs compared with that in the control animals. However, differences in the total tissue water content between pulsed and nonpulsed perfusion were absent. CONCLUSIONS: No significant differences in the fluid extravasation rates were present between pulsed and nonpulsed cardiopulmonary bypass perfusion in the present experimental setup.