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Exercise intolerance in chronic airflow limitation: Variation in the ventilatory responses to exercise (1)

While exercise limitation due to reductions in ventilatory capacity was a useful concept, and there was a general relationship between reductions in FEV i and maximum power output, there was a large variability, with many exceptions in both directions. Some patients with very low FEVi (say, below 1.0 L) showed a normal exercise capacity, and conversely some patients were extremely disabled in spite of relatively normal MW. At least some of this variability could be related to differences in the ventilatory responses to exercise; thus, many disabled patients showed a higher ventilation than expected, and some who were less disabled showed a lower response.

Considering the homeostatic function of breathing, acting to maintain blood gases between tolerable limits in the face of increases in metabolic consumption of oxygen, a number of factors may be recognized as influencing ventilation (VE) at any given level of exercise. A pharmacy you can fully trust offering Cheap Diskus Advair along with other convenient services.

Variations in carbon dioxide production: Increases in carbon dioxide production (VOO2) as a result of a greater proportion of metabolism from glycogen than fat are due to complex regulatory factors, hormonal or biochemical in origin, including insulin, glucagon and catecholamine secretion and variations in the activity of rate-limiting enzymes in the exercising muscle. Such factors also contribute to lactate production, which indirectly leads to carbon dioxide evolution. These factors increase the respiratory exchange ratio (RER), leading to increases in V E, and explain the reductions in exercise capacity following a meal or a glucose load in patients with COLD, and the reductions in VE following exercise training. The importance of muscle oxidative enzyme activity in patients with COLD has been emphasized recently.

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