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Diaphragm Function and Diver Endurance

Diaphragm Function and Diver Endurance

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04679402
Enrollment
45
Registered
2020-12-22
Start date
2022-04-14
Completion date
2024-04-30
Last updated
2024-06-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Respiratory Muscles

Keywords

Control of breathing, Diaphragm function, Gas channels, Blood gases

Brief summary

This project will test the following hypotheses: 1. Training of the inspiratory muscles increases underwater endurance and reduces hypercapnia in divers. 2. Inspiratory muscle training while breathing low concentration carbon monoxide (200 ppm) for 30 minutes daily improves diaphragm performance to a greater degree than the same training breathing air. 3. Inspiratory muscle training increases hypercapnia ventilatory response (gain) in those individuals with a low gain. 4. Variability in oxygen (O2) and carbon dioxide (CO2) permeability of erythrocyte membranes is a determining factor in underwater exercise performance.

Detailed description

The aims of this project are to: (1) test a method that could increase personal endurance and reduce excessive rise in blood carbon dioxide during underwater exercise in divers; and (2) understand the mechanisms by which red blood cells transport oxygen and carbon dioxide and their possible effects on exercise capacity. During underwater exercise, personal endurance capacity and elevated blood PCO2 are key parameters that affect a diver's safety and performance. Unlike exercise on dry land, hypercapnia often occurs during dives and can impair cognitive function and predispose the diver to central nervous system (CNS) oxygen toxicity and convulsions underwater. Some people intrinsically have low ventilatory chemosensitivity, and are more likely to develop hypercapnia during a dive. Lack of stamina may also be a mission-critical variable, and both endurance and the ability to control blood carbon dioxide depend on the respiratory muscle (mainly diaphragm) function, for which endurance capacity is related to mitochondrial number. Previous studies from our lab have demonstrated increased mitochondrial biogenesis with training while breathing a low, sub-toxic (200 ppm) level of carbon monoxide. In this study we will test the effect of daily respiratory muscle training with and without added carbon monoxide on respiratory muscle power, diaphragm thickness, respiratory muscle endurance and exercise endurance during a subsequent dive to 50 feet of sea water. Arterial PCO2 and lactic acid levels will be measured during exercise tests before and after training. Transport of O2 and CO2 through erythrocyte cell membranes occurs mostly through channels. Erythrocytes from volunteers in this study will be tested for O2 and CO2 permeability, and to correlate gas transport efficiency with exercise performance and blood PCO2.

Interventions

OTHERCarbon monoxide 200 ppm in air

Low dose carbon monoxide

Sponsors

Case Western Reserve University
CollaboratorOTHER
Duke University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Masking description

The only person who will know the breathing gas is the trial coordinator. Since carbon monoxide is a colorless, tasteless gas, the subject will be unaware of the group they are in. The gas labeling will be blinded.

Intervention model description

Mixed model with repeated measures

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes

Inclusion criteria

* Normal volunteers * Non-smokers * Range of hypercapnic ventilatory responses * VO2peak ≥35 mL.kg-1.min-1 (males) * ≥30 mL.kg-1.min-1 (females)

Exclusion criteria

* Pregnancy * Cardiorespiratory disease, including hypertension * Neuromuscular disease * Anemia * Hemoglobinopathy, including sickle cell disease and trait

Design outcomes

Primary

MeasureTime frameDescription
Underwater endurance changeBaseline, 6 weeksEndurance during continuous underwater exercise at a depth of 50 ft below the surface
Arterial PCO2 changeBaseline, 6 weeksBlood gases during and at end of exercise
Ventilatory chemosensitivity changeBaseline, 6 weeksHypercapnic ventilatory response (VE.min-1.mmHg)

Secondary

MeasureTime frameDescription
Erythrocyte gas channel analysisBaselineStopped-flow analysis of O2 offloading from Hb of (a) intact RBCs, (b) Hb in hemolysate

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026