TY - JOUR
T1 - Monitoring Changes in Oxygen Muscle during Exercise with High-Flow Nasal Cannula Using Wearable NIRS Biosensors
AU - Contreras-Briceño, Felipe
AU - Espinosa-Ramírez, Maximiliano
AU - Rivera-Greene, Augusta
AU - Guerra-Venegas, Camila
AU - Lungenstrass-Poulsen, Antonia
AU - Villagra-Reyes, Victoria
AU - Caulier-Cisterna, Raúl
AU - Araneda, Oscar F.
AU - Viscor, Ginés
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/11/13
Y1 - 2023/11/13
N2 - Exercise increases the cost of breathing (COB) due to increased lung ventilation (V˙E), inducing respiratory muscles deoxygenation (∇SmO
2), while the increase in workload implies ∇SmO
2 in locomotor muscles. This phenomenon has been proposed as a leading cause of exercise intolerance, especially in clinical contexts. The use of high-flow nasal cannula (HFNC) during exercise routines in rehabilitation programs has gained significant interest because it is proposed as a therapeutic intervention for reducing symptoms associated with exercise intolerance, such as fatigue and dyspnea, assuming that HFNC could reduce exercise-induced ∇SmO
2. SmO
2 can be detected using optical wearable devices provided by near-infrared spectroscopy (NIRS) technology, which measures the changes in the amount of oxygen bound to chromophores (e.g., hemoglobin, myoglobin, cytochrome oxidase) at the target tissue level. We tested in a study with a cross-over design whether the muscular desaturation of
m.vastus lateralis and
m.intercostales during a high-intensity constant-load exercise can be reduced when it was supported with HFNC in non-physically active adults. Eighteen participants (nine women; age: 22 ± 2 years, weight: 65.1 ± 11.2 kg, height: 173.0 ± 5.8 cm, BMI: 21.6 ± 2.8 kg·m
-2) were evaluated in a cycle ergometer (15 min, 70% maximum watts achieved in ergospirometry (V˙O
2-peak)) breathing spontaneously (control, CTRL) or with HFNC support (HFNC; 50 L·min
-1, fiO
2: 21%, 30 °C), separated by seven days in randomized order. Two-way ANOVA tests analyzed the ∇SmO
2 (
m.intercostales and
m.vastus lateralis), and changes in V˙E and ∇SmO
2·V˙E
-1. Dyspnea, leg fatigue, and effort level (RPE) were compared between trials by the Wilcoxon matched-paired signed rank test. We found that the interaction of factors (trial × exercise-time) was significant in ∇SmO
2-
m.intercostales, V˙E, and (∇SmO
2-
m.intercostales)/V˙E (
p < 0.05, all) but not in ∇SmO
2-
m.vastus lateralis. ∇SmO
2-
m.intercostales was more pronounced in CTRL during exercise since 5' (
p < 0.05). Hyperventilation was higher in CTRL since 10' (
p < 0.05). The ∇SmO
2·V˙E
-1 decreased during exercise, being lowest in CTRL since 5'. Lower dyspnea was reported in HFNC, with no differences in leg fatigue and RPE. We concluded that wearable optical biosensors documented the beneficial effect of HFNC in COB due to lower respiratory ∇SmO
2 induced by exercise. We suggest incorporating NIRS devices in rehabilitation programs to monitor physiological changes that can support the clinical impact of the therapeutic intervention implemented.
AB - Exercise increases the cost of breathing (COB) due to increased lung ventilation (V˙E), inducing respiratory muscles deoxygenation (∇SmO
2), while the increase in workload implies ∇SmO
2 in locomotor muscles. This phenomenon has been proposed as a leading cause of exercise intolerance, especially in clinical contexts. The use of high-flow nasal cannula (HFNC) during exercise routines in rehabilitation programs has gained significant interest because it is proposed as a therapeutic intervention for reducing symptoms associated with exercise intolerance, such as fatigue and dyspnea, assuming that HFNC could reduce exercise-induced ∇SmO
2. SmO
2 can be detected using optical wearable devices provided by near-infrared spectroscopy (NIRS) technology, which measures the changes in the amount of oxygen bound to chromophores (e.g., hemoglobin, myoglobin, cytochrome oxidase) at the target tissue level. We tested in a study with a cross-over design whether the muscular desaturation of
m.vastus lateralis and
m.intercostales during a high-intensity constant-load exercise can be reduced when it was supported with HFNC in non-physically active adults. Eighteen participants (nine women; age: 22 ± 2 years, weight: 65.1 ± 11.2 kg, height: 173.0 ± 5.8 cm, BMI: 21.6 ± 2.8 kg·m
-2) were evaluated in a cycle ergometer (15 min, 70% maximum watts achieved in ergospirometry (V˙O
2-peak)) breathing spontaneously (control, CTRL) or with HFNC support (HFNC; 50 L·min
-1, fiO
2: 21%, 30 °C), separated by seven days in randomized order. Two-way ANOVA tests analyzed the ∇SmO
2 (
m.intercostales and
m.vastus lateralis), and changes in V˙E and ∇SmO
2·V˙E
-1. Dyspnea, leg fatigue, and effort level (RPE) were compared between trials by the Wilcoxon matched-paired signed rank test. We found that the interaction of factors (trial × exercise-time) was significant in ∇SmO
2-
m.intercostales, V˙E, and (∇SmO
2-
m.intercostales)/V˙E (
p < 0.05, all) but not in ∇SmO
2-
m.vastus lateralis. ∇SmO
2-
m.intercostales was more pronounced in CTRL during exercise since 5' (
p < 0.05). Hyperventilation was higher in CTRL since 10' (
p < 0.05). The ∇SmO
2·V˙E
-1 decreased during exercise, being lowest in CTRL since 5'. Lower dyspnea was reported in HFNC, with no differences in leg fatigue and RPE. We concluded that wearable optical biosensors documented the beneficial effect of HFNC in COB due to lower respiratory ∇SmO
2 induced by exercise. We suggest incorporating NIRS devices in rehabilitation programs to monitor physiological changes that can support the clinical impact of the therapeutic intervention implemented.
KW - Adult
KW - Cannula
KW - Dyspnea/drug therapy
KW - Female
KW - Humans
KW - Muscles
KW - Oxygen
KW - Spectroscopy, Near-Infrared
KW - Wearable Electronic Devices
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85177866635&partnerID=8YFLogxK
U2 - 10.3390/bios13110985
DO - 10.3390/bios13110985
M3 - Article
C2 - 37998160
AN - SCOPUS:85177866635
SN - 2079-6374
VL - 13
SP - 1
EP - 17
JO - Biosensors
JF - Biosensors
IS - 11
M1 - 985
ER -