Pulmonary mechanisms and work of breathing at maximal ventilation and raised air pressure

Pulmonary ventilation (V) and the interrelationships of airflow, transpulmonary pressure, and lung volume during inspiration and expiration were studied in eight healthy subjects who performed maximal exercise (MEx; 140% VO2 max), 15-s maximal voluntary ventilation (MVV), and forced inspiratory and expiratory vital capacity (FVC) maneuvers at 1, 3, and 6 ATA. Maximal exercise ventilation and MVV amounted to 149 +/- 7 (mean +/- SE) and 193 +/- 9 l . min-1, respectively, at 1 ATA and were both reduced by approximately 37% at 3 ATA and by 50% at 6 ATA. Expiratory peak flows during MEx and MVV were equal to the maximal flows obtained during FVC at comparable lung volumes, whereas inspiratory peak flows during MEx were 20% less than the FVC flows. Despite a sixfold increase in gas density, the rate of mechanical work of breathing decreased when the pressure was raised to 6 ATA, during MEx from 8 +/- 1 to 6 +/- 1 W, and during MVV from 28 +/- 5 to 18 +/- 3 W. With increasing gas density there was a shift of lung volumes in the inspiratory direction with consequent reductions of inspiratory-to-expiratory flow ratios. We conclude that depletion of energy stores in the inspiratory muscles contributed to limiting V during MEx at raised air pressure.