Measurement of anaerobic threshold in chronic airflow obstruction

We compared determinations of anaerobic threshold (AT) made from measurements of arterial lactate concentration with AT determined from ventilatory response measurements of subjects with chronic airflow obstruction (CAO). Six untrained subjects with CAO performed incremental maximal cycle ergometer tests. Ventilation (VE); O2 uptake (VO2), CO2 output (VCO2); end-tidal CO2 fraction (FETCO2); and end-tidal O2 fraction (FETO2) were measured breath by breath. Arterial lactate concentration was sampled at rest and every 30 s during exercise from an indwelling arterial catheter. For three subjects with more severe airflow obstruction, plots of VE/VO2 and FETO2 failed to detect AT. In contrast, a systematic increase of the respiratory gas exchange ratio across the lung (R) accompanied increasing arterial lactate concentrations in all 6 subjects. We conclude that progressive increases of VE/VO2 and FETO2 cannot be relied upon for the measurement of AT in patients with severe CAO. Progressive increases of R unaccompanied by decreasing FETCO2 detect AT in CAO.