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| Name | Class |
|---|---|
| Case Western Reserve University | OTHER |
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This project will test the following hypotheses:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Respiratory Muscle Training Breathing Low Dose Carbon Monoxide | Experimental | Carbon monoxide 200 ppm in air breathing during daily 30 minute inspiratory loading training sessions. Subjects will breathe the experimental gas through a mouthpiece with nose-clip in place. |
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| Respiratory Muscle Training Breathing Air | Sham Comparator | Air breathing during daily 30 minute inspiratory loading training sessions. Subjects will breathe air through a mouthpiece with nose-clip in place. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Carbon monoxide 200 ppm in air | Other | Low dose carbon monoxide |
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| Measure | Description | Time Frame |
|---|---|---|
| Underwater endurance change | Endurance during continuous underwater exercise at a depth of 50 ft below the surface | Baseline, 6 weeks |
| Arterial PCO2 change | Blood gases during and at end of exercise | Baseline, 6 weeks |
| Ventilatory chemosensitivity change | Hypercapnic ventilatory response (VE.min-1.mmHg) | Baseline, 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Erythrocyte gas channel analysis | Stopped-flow analysis of O2 offloading from Hb of (a) intact RBCs, (b) Hb in hemolysate | Baseline |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard E Moon, MD | Duke University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Duke University Medical Center | Durham | North Carolina | 27710 | United States |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Jan 29, 2024 | Jun 11, 2024 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D000388 | Air |
| ID | Term |
|---|---|
| D001272 | Atmosphere |
| D004777 | Environment |
| D055669 | Ecological and Environmental Phenomena |
| D001686 | Biological Phenomena |
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Mixed model with repeated measures
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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.
| D008685 |
| Meteorological Concepts |
| D004778 | Environment and Public Health |