During an incremental exercise test, three consequences of the onset of anaerobic metabolism can be observed: rise in blood lactate (lactate threshold, LT); fall in standard bicarbonate (lactic acidosis threshold, LAT); nonlinear increase in CO2 output (V-slope gas exchange threshold, GET). We compared these thresholds in 31 patients with COPD. We found that the GET and LAT overestimated the LT. A better relationship was found between LAT and GET, even though GET was significantly higher than LAT (by 124 ml/min; p <0.0001). However, since the bias is appreciably greater at lower LAT values (likely because V̇CO2 kinetics are slower than V̇O2 kinetics), we separated the studies into two groups: (A) tests where LAT occurred within the first 2 min of the increasing work rate period, and (B) tests where LAT occurred after 2 min. For Group A, there was a substantial bias between LAT and GET (323 ml/min, p <0.0001), whereas the bias was much smaller (only 5.4%, though statistically significant) for Group B (57 ml/min, p <0.01). We conclude that when lactic acidosis occurs after the first 2 min of incremental exercise, the GET closely approximates the point at which blood bicarbonate begins to fall.
|Number of pages||5|
|Journal||American Review of Respiratory Disease|
|Publication status||Published - 1993|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine