Parks, Jordan K.

AbstractIntermittent hypoxia has been used to enhance oxygen delivery in athletes and patients; however, it is unclear whether acute exposure is sufficient to elicit lasting physiologic adaptation(s). The purpose of this study was to evaluate physiologic response(s) to hypobaric‐hypoxic (HH) exercise. Nine participants (4 M/5F; 37.9 ± 12.7 yrs.; 174.3 ± 9.4 cm; 75.3 ± 15.9 kg; 24.4 ± 3.4 kg/m2) were exposed to progressively higher simulated altitudes and completed two HH submaximal exercise sessions (~30 min ea., ≥72 h apart) on a cycle ergometer at the first altitude that posed a significant challenge to them. Altitude was dependent on individual response as determined from heart rate (HR), peripheral oxygenation (SpO2), and the ratio of HR response to SpO2 (HR/SpO2). Statistical analyses included paired samples t‐test (p ≤ 0.05). No significant change in SpO2 (HH‐1: 85 ± 4% vs. HH‐2: 85 ± 4%, p = 0.684) was observed between sessions. However, there were significant decreases in: HR (HH‐1: 150 ± 18 bpm vs. HH‐2: 133 ± 27 bpm, p = 0.001) of 18 bpm (11%); HR/SpO2 (HH‐1: 1.76 ± 0.22 vs. HH‐2: 1.57 ± 0.33, p = 0.012); and RPE (HH‐1: 15 ± 2 vs. HH‐2: 11 ± 4, p = 0.017). While workload significantly increased (HH‐1: 89 ± 36 W vs. HH‐2: 105 ± 36 W, p = 0.024). Some participants had a threshold/challenging altitude, but from a single bout there is evidence of improved tolerance that can last over a week. Further investigation is required to replicate and understand possible mechanisms.

Parks, Jordan K, Courtney M. Wheatley-Guy, Glenn M. Stewart, Caitlin C. Fermoyle, Bryan J. Taylor, Jesse Schwartz, Briana Ziegler, Kay Johnson, Alice Gavet, Loïc Chabridon, Paul Robach, and Bruce D. Johnson. Lung “Comet Tails” in healthy individuals: accumulation or clearance of extravascular lung water? High Alt Med Biol. 24:230–233, 2023—Ultrasound lung comet tails (or B-lines) tend to be limited in number (<5) or absent under ultrasound examination, and the appearance of diffuse B-lines with lung sliding has been suggested to identify pulmonary edema. Clinical evaluation of B-lines has been utilized as a bedside test to assess pulmonary congestion in patients with heart failure. Exposure to altitude or prolonged exercise can alter fluid regulation and can lead to pulmonary congestion or edema. As such, B-lines have been utilized in the field to monitor for pathological lung fluid accumulation. However, ultrasound lung comet lines might not be as reliable for identifying extravascular lung water (EVLW) as previously thought in healthy individuals exercising at altitude where an increase in the number of ultrasound lung comets would reflect fluid buildup in the interstitial space of the alveoli and pulmonary capillaries. This report will focus on reviewing the literature and our data from a group of ultraendurance runners that completed the Ultra Trail Mont Blanc race that demonstrates that lung comet tails may not always be evidence of pathological fluid accumulation in healthy individuals and as such should be used to assess EVLW in concert with other diagnostic testing.