Involuntary breathing movements improve cerebral oxygenation during apnea struggle phase in elite divers

• Published in: Journal of applied physiology (1985) 2009-12, Vol.107 (6), p.1840-1846
• Main Authors: Dujic, Zeljko, Uglesic, Lovro, Breskovic, Toni, Valic, Zoran, Heusser, Karsten, Marinovic, Jasna, Ljubkovic, Marko, Palada, Ivan
• Format: Article
• Language: English
• Subjects: Adult; Apnea - physiopathology; Biological and medical sciences; Blood; Blood Pressure; Cerebrovascular Circulation - physiology; Diving; Diving - physiology; Effects; Female; Fundamental and applied biological sciences. Psychology; Heart Rate; Hemoglobins - physiology; Homeostasis - physiology; Humans; Hypercapnia - physiopathology; Male; Oxygen; Oxygen Consumption - physiology; Pulmonary Gas Exchange - physiology; Respiration; Signal Processing, Computer-Assisted; Spirometry; Vascular Resistance - physiology
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/japplphysiol.00334.2009

1 Department of Physiology, University of Split School of Medicine, Split, Croatia; and ; 2 Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany Submitted 30 March 2009 ; accepted in final form 15 October 2009 We investigated whether the involuntary breathing movements (IBM) during the struggle phase of breath holding, together with peripheral vasoconstriction and progressive hypercapnia, have a positive effect in maintaining cerebral blood volume. The central hemodynamics, arterial oxygen saturation, brain regional oxyhemoglobin (bHbO 2 ), deoxyhemoglobin, and total hemoglobin changes and IBM were monitored during maximal dry breath holds in eight elite divers. The frequency of IBM increased (by 100%), and their duration decreased ( 30%), toward the end of the struggle phase, whereas the amplitude was unchanged (compared with the beginning of the struggle phase). In all subjects, a consistent increase in brain regional deoxyhemoglobin and total hemoglobin was also found during struggle phase, whereas bHbO 2 changed biphasically: it initially increased until the middle of the struggle phase, with the subsequent relative decline at the end of the breath hold. Mean arterial pressure was elevated during the struggle phase, although there was no further rise in the peripheral resistance, suggesting unchanged peripheral vasoconstriction and implying the beneficial influence of the IBM on the cardiac output recovery (primarily by restoration of the stroke volume). The IBM-induced short-lasting, sudden increases in mean arterial pressure were followed by similar oscillations in bHbO 2 . These results suggest that an increase in the cerebral blood volume observed during the struggle phase of dry apnea is most likely caused by the IBM at the time of the hypercapnia-induced cerebral vasodilatation and peripheral vasoconstriction. breath hold; cerebral autoregulation; near-infrared spectroscopy; diaphragmatic movements Address for reprint requests and other correspondence: Z. Dujic, Dept. of Physiology, Univ. of Split School of Medicine, Soltanska 2, 21000 Split, Croatia (e-mail: zeljko.dujic{at}mefst.hr ).