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[Exercise-induced asthma and arterial hypoxemia].

M Scherrer, M Geiger, K Kyd

    Schweizerische Medizinische Wochenschrift
    |November 20, 1982
    PubMed
    Summary
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    Asthma patients may experience two distinct airway constrictions after exercise. One affects large airways, causing a drop in FEV1, while the second impacts small airways, leading to arterial hypoxemia.

    Area of Science:

    • Respiratory Medicine
    • Exercise Physiology
    • Pulmonary Function Testing

    Background:

    • Exercise can trigger bronchoconstriction in asthmatic individuals.
    • Post-exercise airway responses in asthma are complex and not fully understood.
    • Understanding these responses is crucial for managing exercise-induced asthma.

    Purpose of the Study:

    • To investigate the nature and timing of post-exercise airway constriction in young asthmatic patients.
    • To differentiate between large and small airway involvement during exercise recovery.
    • To explore the relationship between FEV1 changes and arterial oxygen levels.

    Main Methods:

    • 40 young asthmatic patients underwent submaximal treadmill exercise.
    • Arterial oxygen partial pressure (PaO2) and forced expiratory volume in 1 second (FEV1) were monitored during post-exercise recovery.

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  • Patients were categorized into subgroups based on FEV1 and PaO2 levels.

    • Main Results:

    • 20 patients developed arterial hypoxemia (PaO2 < 77.5 mm Hg) during recovery.
    • Subgroup A showed hypoxemia with reduced FEV1, while Subgroup B had hypoxemia with normal FEV1.
    • Hypoxemia onset was delayed relative to FEV1 drop in Subgroup A, and progressive hypoxemia occurred despite FEV1 normalization.

    Conclusions:

    • Two sequential bronchoconstrictions likely occur post-exercise due to airway cooling.
    • The first constriction affects large airways (FEV1 drop), and the second affects small airways (PaO2 drop).
    • Adrenaline can abolish the large airway response, highlighting the importance of the small airway response in protecting alveoli.