Blood Lactate Levels Research Articles

PREDICTIVE VALUE OF UMBILICAL ARTERIAL BLOOD LACTATE IN NEONATES WITH MECONIUM-STAINED LIQUOR

This research aims to determine the clinical and maternal variables contributing to increased lactate levels and determine the prognostic usefulness of umbilical cord blood lactate levels in neonates through meconium-stained liquor. The study was conducted between 01 June 2022 and 31 May 2023 at the Department of Neonatology, CMH Rawalpindi. This study included 100 newborns with meconium aspiration syndrome (MAS) in a thin cross-sectional design. Newborn babies received treatment at CMH Hospital throughout the approved period, and observations of umbilical cord blood have been obtained for lactate measurement and arterial blood gas analysis. Furthermore, information on post-delivery problems and neonatal features was retrieved using hospital records. The research included comprehensive statistical analyses, encompassing both Bivariate and multivariate evaluations, to pinpoint the variables linked to increased lactate levels and their potential predictive significance for unfavorable neonatal outcomes. This study included 720 unpaired samples of cord blood from the umbilical artery. The lactate result had an interquartile range of 4.0–6.2 mmol/L and a mean of 5.49 mmol/L (± SD 2.44 mmol/L). After birth, resuscitation was required for a considerably more significant number of neonates with increased lactate levels (25.1%) than for those who had lesser lactate levels (1.3%). At five minutes, Apgar scores of less than seven also showed a significant correlation between high lactate levels and a greater incidence of asphyxia (19.8%). Meconium-stained liquor (aOR=5.85), primigravidity (aOR=2.78), male sex (aOR=1.71), and oxytocic administration (OR=1.97) were factors linked to elevated lactate levels. The results highlight the prognostic significance of umbilical cord blood lactate levels in newborn outcomes, particularly while considering the necessity for resuscitation, asphyxia, and diagnosis such as hypoxic encephalopathy. Elevated lactate levels are more likely in cases where maternal and clinical variables are present, such as primigravidity and liquor stained with meconium. This study underscores the feasibility of including lactate measures from umbilical cord blood into standard evaluations of neonates, providing a valuable instrument for prompt identification and remediation. Prospective investigations and multi-center trials are necessary to confirm these results and investigate the long-term effects of increased lactate levels on newborn health.

Psychophysiological Responses in Soldiers during Close Combat: Implications for Occupational Health and Fitness in Tactical Populations.

This study explores the psychophysiological responses and subjective exertion experiences of soldiers in simulated hand-to-hand combat, aligning these findings with established physiological benchmarks. Active military personnel were monitored for heart rate, blood lactate levels, subjective exertion, cortical arousal, and muscle strength during combat scenarios. The results showed significant increases in heart rate and blood lactate, indicating intense cardiovascular demands and a reliance on anaerobic energy systems. Contrary to these physiological changes, soldiers reported lower levels of exertion, suggesting a possible underestimation of physical effort or individual differences in perception and mental resilience to stress. Notably, a decrease in cortical arousal post-combat was observed, potentially signaling cognitive function deficits in decision-making and information processing in high-stress environments. This decline was more pronounced than typically seen in other high-stress situations, highlighting the unique cognitive demands of hand-to-hand combat. Additionally, an increase in muscle strength was noted, underscoring the physiological adaptations arising from intensive combat training. These findings provide valuable insights into the psychophysiological effects of hand-to-hand combat, emphasizing the complex interplay between physical exertion, cognitive function, and stress response in military contexts. The study underscores the need for comprehensive training strategies that address both physical and psychological aspects to enhance combat readiness and decision-making under stress.

The significance of admission blood lactate and fibrinogen in pediatric traumatic brain injury: a single-center clinical study

BackgroundTraumatic brain injury (TBI) is a significant cause of morbidity and mortality in pediatric patients, leading to long-term physical, cognitive, and psychological impairments. Blood lactate and fibrinogen levels have emerged as potential biomarkers associated with tissue hypoperfusion and coagulation dysfunction, respectively. However, limited research has specifically focused on the significance of these biomarkers in pediatric TBI. This study aimed to investigate the clinical significance of blood lactate and fibrinogen levels upon admission in pediatric patients with traumatic brain injury.MethodsThe medical records of 80 children with a traumatic brain injury who were admitted from January 2017 to January 2021 were retrospectively analyzed. The two groups were compared according to whether the blood lactate in the admission arterial blood gas increased and the fibrinogen content in the coagulation function decreased. The clinical data of the children in the two groups were different, and then they were divided into a good prognosis group and a poor prognosis group according to the GOS prognostic score, and the differences in the clinical indicators of the two groups were compared.ResultsAmong the 80 patients, 33 had elevated blood lactate levels, 34 had decreased fibrinogen levels, and 29 had an unfavorable outcome (GOS < 4). Compared to the normal blood lactate group, there were no statistically significant differences in age, sex ratio, or platelet count in the elevated blood lactate group (P > 0.05). However, the elevated blood lactate group had lower Glasgow Coma Scale (GCS) scores upon admission, higher blood lactate levels, lower fibrinogen levels, longer hospital stay, lower GOS scores, and a higher proportion of GOS < 4 (P < 0.05). Compared to the normal fibrinogen group, there were no statistically significant differences in age, sex ratio, or platelet count in the decreased fibrinogen group (P > 0.05). However, the decreased fibrinogen group had lower GCS scores upon admission, higher blood lactate levels, lower fibrinogen levels, longer hospital stays, lower GOS scores, and a higher proportion of GOS < 4 (P < 0.05). Compared to the favorable outcome group, there were no statistically significant differences in age, sex ratio, or platelet count in the unfavorable outcome group (P > 0.05). However, the unfavorable outcome group had lower GCS scores upon admission, higher blood lactate levels, lower fibrinogen levels, longer hospital stays, a higher incidence of pulmonary infection, a higher incidence of stress ulcers, and lower GOS scores (P < 0.05).ConclusionThe levels of blood lactate and fibrinogen may represent the severity of children with traumatic brain injury and may be risk factors for poor prognosis of children with traumatic brain injury.

Long-term normothermic autoperfusion of the cardiopulmonary complex ex vivo as a method of effective graft conditioning: an experimental study

Objective: To compare the effectiveness of 6-hour normothermic autoperfusion of a heart graft ex vivo with pharmaco-cold preservation using Bretschneider's solution (Custodiol, Dr Franz Köhler Chemie GmbH, Bensheim, Germany).Methods: Landrace pigs weighing 50 ± 5 kg and aged 4–5 months (n = 10) were selected as a model for a series of acute experiments. Cardiopulmonary conditioning using autoperfusion was conducted for 6 hours on the experimental group (n = 5). On the other hand, the control group underwent a 6-hour pharmaco-cold preservation with Bretschneider solution to recover the heart's pumping function. Graft preservation effectiveness was evaluated by measuring hemodynamic parameters, heartbeat, and myocardial ischemia marker concentrations.Results: After reperfusion and isolation of the working cardiopulmonary complex, cardiac output was 0.63 [0.37; 0.8] L/min and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (P &lt; .05). The levels of CPK-MB, LDH, troponin-I, and lactate in the coronary sinus blood was significantly higher in the control group.Conclusion: The study demonstrated significant benefits of normothermic autoperfusion in maintaining the morphofunctional status of the donor heart compared to pharmaco-cold preservation using Bretschneider's solution for 6 hours of ex vivo graft conditioning. Received 16 July 2023. Revised 8 September 2023. Accepted 11 September 2023. Funding: The study was carried out within the framework of project No. 23-25-10013 (agreement No. 23-25-10013 dated April 20, 2023 with the Russian Science Foundation, agreement No. р-52 dated April 3, 2023 with the Ministry of Science and Innovation Policy of the Novosibirsk Region). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, I.S. ZykovData collection and analysis: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. SirotaStatistical analysis: M.O. ZhulkovDrafting the article: M.O. ZhulkovCritical revision of the article: M.O. Zhulkov, D.A. Sirota, I.S. ZykovFinal approval of the version to be published: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. Sirota

Effects of photobiomodulation applied at different times on functional performance and ergogenic response of rugby athletes: Randomized clinical trial

BackgroundPhotobiomodulation (PBM) is indicated to accelerate the recovery of athletes and reduce muscle damage caused by physical exercise. The objective of this study was to establish the best time to apply photobiomodulation to increase the functional performance and ergogenic response of rugby athletes. MethodsRandomized crossover clinical trial with 18 rugby athletes of both sexes. The interventions were carried out from January to May 2019. The blood levels of creatine kinase (CK) and lactate, and performance in the Modified Star Excursion Balance Test, Single Hop Test, Triple Hop Test, Bangsbo Sprint test (BST), and Yo-Yo intermittent recovery level 1 (YoyoIR1) were evaluated. The athletes underwent two blocks of exercises with the BST and Yoyo-IR1, as well as the random application of four interventions: without application of photobiomodulation (CO), pre-exercise photobiomodulation (PBpre), PBM during the exercise interval (PBint), or post-exercise photobiomodulation (PBpos). The photobiomodulation using light-emitting diodes (850 nm, 8 J/cm2) lasted 10 min and was applied to the quadriceps, hamstrings, and triceps surae muscles. The results were compared between groups and times, and the effect size for the interventions was established. ResultsNo differences were found between groups in CK, lactate, and performance in the functional tests between groups and times. Only the PBpre presented improved performance in the first Yoyo-1R1 test (p < 0.01), while the PBint improved in the second Yoyo-IR1 test and BST (p < 0.05). ConclusionThe PBM did not change muscle damage markers or performance in the functional tests. For an ergogenic response, photobiomodulation applied before exercise improves performance, which can be maintained when PBM is performed in the exercise interval.

Enhanced anti-fatigue and exercise performances due to Huáng qí polysaccharide supplementation in mice

In modern society, people have busy and competitive lives, with different stresses causing fatigue and overwork, which may ultimately harm their health. We investigated the beneficial effects of Astragalus polysaccharide (rAPS) on fatigue and exercise performance. Forty male Institute of Cancer Research (ICR) mice were randomly divided into four groups according to body weight (BW): control group (distilled water), 1-fold dose group (0.70 g rAPS/kg BW/day), 2-fold dose group (1.40 g rAPS/kg BW/day) and a 5-fold dose group (3.50 g rAPS/kg BW/day). In terms of exercise performance, rAPS supplementation significantly improved grip strength performance and time to exhaust-loaded swim times when compared with controls (p < 0.05). Moreover, rAPS supplementation significantly reduced fatigue-related biochemical parameters, including blood lactate and BUN levels, while significantly improve muscle strength and swimming endurance times t(p < 0.05). Hence, we recommend that rAPS elicit antifatigue and performance-enhancing health benefits.

Ghrelin-responsive mediobasal hypothalamic neurons mediate exercise-associated food intake and exercise endurance.

Previous studies have implicated the orexigenic hormone ghrelin as a mediator of exercise endurance and the feeding response postexercise. Specifically, plasma ghrelin levels nearly double in mice when they are subjected to an hour-long bout of high-intensity interval exercise (HIIE) using treadmills. Also, growth hormone secretagogue receptor-null (GHSR-null) mice exhibit decreased food intake following HIIE and diminished running distance (time until exhaustion) during a longer, stepwise exercise endurance protocol. To investigate whether ghrelin-responsive mediobasal hypothalamus (MBH) neurons mediate these effects, we stereotaxically delivered the inhibitory designer receptor exclusively activated by designer drugs virus AAV2-hSyn-DIO-hM4(Gi)-mCherry to the MBH of Ghsr-IRES-Cre mice, which express Cre recombinase directed by the Ghsr promoter. We found that chemogenetic inhibition of GHSR-expressing MBH neurons (upon delivery of clozapine-N-oxide) 1) suppressed food intake following HIIE, 2) reduced maximum running distance and raised blood glucose and blood lactate levels during an exercise endurance protocol, 3) reduced food intake following ghrelin administration, and 4) did not affect glucose tolerance. Further, HIIE increased MBH Ghsr expression. These results indicate that activation of ghrelin-responsive MBH neurons is required for the normal feeding response to HIIE and the usual amount of running exhibited during an exercise endurance protocol.

Diagnostic and Prognostic Value of Blood Lactate Level in Adult Acute Gastrointestinal Bleeding Patients Admitted to the Emergency Department

Diagnostic and Prognostic Value of Blood Lactate Level in Adult Acute Gastrointestinal Bleeding Patients Admitted to the Emergency Department

The first results of the international multicenter clinical study RheoSTAT-CP0669 on the effectiveness and safety of infusion solution Rheosorbilact® in the complex treatment of patients with burns

Mechanization and urbanization are accompanied by an increase in the prevalence of burns. A burn causes both local damage and systemic inflammatory response that leads to inadequate oxygen delivery to vital organs and inadequate elimination of metabolites. Infusion therapy for burns aims to restore perfusion and prevent ischemia. The implementation of effective dynamic schemes of infusion therapy has led to a decrease in mortality, however, an excessive amount of injected fluid does not improve the patient’s volumetric status, instead increasing tissue swelling and causing a number of complications. Therefore, doctors are faced with the question of choosing the optimal infusion therapy, which will allow maintaining the patient’s status at the needed level called normovolemia. According to the results of the open, blinded evaluation of the randomized controlled trial RheoSTAT-СР0669, administration of Rheosorbilact to patients with burns by intravenous infusion at a dose of 200-400 ml/day for 3 days significantly improves the clinical condition, reduces the manifestations of (poly-) organ failure and endogenous intoxication. Small-volume infusion therapy with Rheosorbilact causes a statistically significant decrease in the breathing rate, a decrease in endogenous intoxication and the intensity of inflammation, as well as positive dynamics of the blood gas composition. Administration of the drug in this mode has a favorable safety profile: it does not lead to fluid overload, associated complications, or other serious undesirable side effects, and does not cause a clinically significant increase in blood lactate level. The RheoSTAT-СР0669 study substantiates the feasibility of using Rheosorbilact in the complex therapy of burns.

Paediatric Risk of Mortality (PRISM) III Score and Serum Lactate Levels as Predictor of Outcome in Children Admitted to the Paediatric Intensive Care Unit

Objective − To evaluate prognostic indicators of mortality in children admitted to the Paediatric Intensive Care Unit (PICU) and to correlate blood lactate levels with Pediatric Risk of Mortality (PRISM) III scores.Methods − A cross sectional study was conducted between March 2021 and October 2022 in the PICU of the P S Govindasamy (PSG) Institute of Medical Sciences and Research. On the basis of the laboratory and clinical parameters, the PRISM III score was calculated at admission. Lactate levels were measured at admission and 24 hours after admission.Results − The study included 107 patients of whom the majority (54.2%) were female. The median patient age was 3 years and the median duration of PICU stay was 4 days. Among the hospitalized patients, 90.7% were survivors, with female patients having an 8.8-fold higher risk of mortality compared to males (P=0.05). The serum lactate value in survivors (2.95 mmol/L) was much lower in comparison to non-survivors (3.11 mmol/L). The PRISM III value measured at the time of admission in survivors (8) was low when compared to non-survivors (16.50). The area under the curve (AUC) for PRISM III was 0.884 compared to lactate levels (0.831).Conclusion − A significant positive correlation was seen between the PRISM III score and lactate levels. The study indicates that monitoring patients admitted to the PICU in relation to their PRISM III score and lactate levels can improve their overall prognosis and facilitate early resuscitation.

Prehospital blood gas analyses in acute patients treated by a ground-based physician-manned emergency unit: a cohort study

BackgroundThe prehospital patients treated by ambulances and mobile emergency care units (MECU) are potentially critically ill or injured. Knowing the risks of serious outcomes in these patients is important for guiding their treatment. Some settings allow for prehospital arterial blood gas analyses. This study aimed to assess the outcomes of prehospital patients in relation to their prehospitally measured lactate, pH, and CO2 levels. The primary outcome was 7-day mortality.MethodsThis register-based cohort study included patients with one or more prehospital blood gas analyses during their prehospital treatment by a physician-manned MECU, from January 2015 to December 2018. The blood samples were analyzed on an ABL90 Flex analyzer. Absolute values with percentages and odds ratios (OR) with 95% confidence intervals (CI) were calculated for the primary and secondary outcomes within prespecified subgroups.ResultsThe study included 745 patients, with an overall 7-day mortality rate of 20.0%.Lactate levelThe 7-day mortality rates were 11.5% in patients with normal lactate levels (< 2.0 mmol/L), 14.4% with intermediate lactate levels (2.0–3.9 mmol/L), and 33.0% with high lactate levels (≥ 4.0 mmol/L). This corresponded to an OR of 1.30 (95% CI: 0.75–2.24) in the intermediate lactate group (2.0–3.9 mmol/L) and an OR of 3.77 (95% CI: 2.44–5.85) in the high lactate group (≥ 4.0 mmol/L), compared to the reference group with normal lactate.pH levelThe ORs of 7-day mortality rates were 4.82 (95% CI: 3.00–7.75) in patients with blood pH of < 7.35 and 1.33 (95% CI: 0.65–2.72) in patients with blood pH > 7.45, compared to the reference group with normal pH (7.35–7.45).CO2 levelThe ORs of 7-day mortality rates were 2.54 (95% CI: 1.45–4.46) in patients with blood CO2 of < 4.3 kPa and 2.62 (95% CI: 1.70–4.03) in patients with blood CO2 > 6.0 kPa, compared to the reference group with normal CO2 (4.3–6.0 kPa).ConclusionsThis study found a strong correlation between increasing 7-day mortality rates and high blood lactate levels, low levels of pH, and abnormal CO2 blood levels, in prehospital patients undergoing prehospital blood analysis.

Benefits of an accelerated climatotherapy programme for busy people: comparisons according to area and season.

An accelerated climatotherapy programme was evaluated for use with busy people inmid-mountain and flat lowland areas. A total of 43 urban residents participated in this climatotherapy programme. Participants' blood pressure, pulse rate, peripheral skin temperature and levels of salivary amylase, salivary cortisol and blood lactate were measured, and they completed the Profile of Mood Status questionnaire. In the mid-mountain area, which had a cooler environment and long uphill paths, participants' percentage of maximum pulse rate (70.01%) to estimated maximum heart rate was higher than that (59.67%) of participants in the flat lowland area, suggesting that the mid-mountain area was suitable for endurance training. At both sites, the decrease in peripheral skin temperature during the climatic terrain cure suggested that our programme was properly implemented with a cool body surface in accordance with our purpose. Negative moods improved quickly, suggesting that the forest environment and the fresh-air rest cure may have relaxed participants. In late spring and early autumn, the mood of approximately 25% of participants improved to an Iceberg profile, which is associated with positive mental states and athletic peak performance, after climatotherapy. On the other hand, the weather in early spring and late autumn was more likely to facilitate maintenance of a cool body surface during the climatic terrain cure. With the support of individualized feedback provided after the climatotherapy sessions, three participants developed regular exercise habits, serving as a good example of the effectiveness of our climatotherapy programme to elicit behavioural change.

Lactate levels in the brain and blood of schizophrenia patients: A systematic review and meta-analysis

BackgroundThe pathophysiological mechanisms of schizophrenia are still unclear. Converging evidence suggests that energy metabolism abnormalities are involved in schizophrenia, and support its role in the pathophysiology of this disease. Lactate plays an important role in energy metabolism. Many studies have reported changes in the levels of lactate in the brain and serum of schizophrenia patients; however, the results from these studies are not consistent. To overcome this limitation, the goal of the present meta-analysis is to analyze the changes in lactate levels in the brain and blood of schizophrenia patients. MethodsFor this systematic review and meta-analysis, we performed a thorough search of relevant literature in the English language, using the MEDLINE, Cochrane, and Embase databases. ResultsIn the present meta-analysis, 20 studies were scrutinized, including 13 studies on brain lactate levels, which involved 322 schizophrenia patients and 324 healthy individuals as controls. 7 studies on blood lactate levels, involving 234 schizophrenia patients and 238 healthy individuals, were also included. Brain lactate levels were elevated in schizophrenia patients, both in vivo and in post-mortem studies. Nevertheless, blood lactate levels in schizophrenia patients have revealed no statistically significant difference, as compared with control individuals. ConclusionsIn comparison with healthy individuals, schizophrenia patients had higher lactate levels in the brain, rather than in the blood. These findings suggest independent regulatory mechanisms of lactate levels in the brain and peripheral tissues. Abnormal lactate metabolism in the brain may be an important pathological mechanism in schizophrenia.

Management of Critically Ill Patients with Severe Diabetic Ketoacidosis and Acute Renal Failure: A Case Report

Background: Diabetic ketoacidosis (DKA) is one of the hyperglycemic crises related to diabetes. The main problem in DKA is ketogenesis, a metabolic process that increases the production and decreases the utilization of ketones. DKA is characterized by a biochemical triad such as hyperglycemia, ketonemia, and high anion gap metabolic acidosis. Management of DKA needs to be carried out appropriately and immediately because it may lead to diabetic coma and death.&#x0D; Case presentation: A 38-year-old woman had decreased consciousness due to metabolic encephalopathy as a complication of severe DKA. The metabolic derangement shows an overlapping high anion gap metabolic acidosis and non-anion gap metabolic acidosis. This case is complicated by acute renal failure. The patient also had been in a hypovolemic state, causing pre-renal acute kidney injury. We treat the patient using a balanced solution to correct hypovolemia. Sonography of the vena cava and blood lactate levels are used to guide fluid resuscitation. We intubate and control the patient's breathing to reduce the metabolic demand. We titrate the insulin infusion until the ketogenesis process is abolished. Antibiotics are given based on sputum culture.&#x0D; Conclusion: Acute renal failure (ARF) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA). Early recognition and aggressive treatment of ARF during DKA may improve the prognosis of these patients.

Liver Enzymes and Blood Lactate Profile of Patients Diagnosed with Typhoid Fever in Abuja, Nigeria

Salmonella enterica serotype Typhi antibiotics resistance is on the increase and this frustrates efforts at treatment. Persistence of drug-resistant typhoid fever leads to higher mortality rate because treatment is evasive. Lactate is a marker of the severity of stress response in illnesses and liver function enzymes are indicative of the health of the liver. This study intended to identify the effect of drug resistant typhoid fever infection on liver enzymes and blood lactate levels of patients diagnosed with typhoid fever. Fifty subjects were recruited, forty-five were positive for Widal test and further subjected to stool culture examination for the identification of Salmonella Typhi. All patient’s blood were analysed for lactate, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Salmonella Typhi were identified in eight out of forty-five Widal positive test patients. The eight positive Salmonella Typhi isolates showed resistance to the Amoxicillin (30 mcg), Tetracycline(30 mcg), Cotrimoxazole (25 mcg), Ceftriazone (30 mcg), Levofloxacin (5 mcg), Gentamicin (30 mcg) and Netillin (30 mcg) but showed susceptibility to ofloxacin (5 mcg). ALP (158.1±8.32 IU/L), AST(55.1±6.78 U/L), ALT (65.2 ±4.96U/L) and blood lactate (10.5±2.4 mmol/L), were elevated in all drug resistant patients when compared to reference standard ALT (7-56 U/L), AST (10-40 U/L), ALP (20-120IU/L), lactate (0.8-2.2 mmol/L). ALT, AST and ALP enzyme levels increased with increasing number of resistances to antibiotics. Untreated typhoid fever infection exerts metabolic toll on liver functions.

Tolerability of an Individualized Physical Rehabilitation Program in Patients Dependent on Inotropic Support With End-Stage Chronic Heart Failure

Aim To assess the tolerability of an individualized physical rehabilitation program (PRP) in inotrope-dependent patients with end-stage chronic heart failure (CHF).Material and methods This prospective randomized study included 120 men aged 18-65 years with left ventricular ejection fraction ≤30 % and blood pressure ≥90 / 60 mm Hg. Patients who have received dobutamine or dopamine for ≥2 weeks were randomized into two groups: group 1, 40 patients who participated in the PRP and group 2, 40 patients who did not participate in the PRP. Group 3 included 40 patients without inotropic support who participated in the PRP.Results Patients of groups 1 and 3 attended &gt;80 % of the scheduled classes without developing life-threatening adverse events (AEs) associated with exercise (E). After 6 months of the study, the exercising patients achieved a comparable (average) E intensity: 44 [35; 50]% and 45 [40;52]% of heart rate reserve and Borg scale scores 14 [12; 14] and 13 [11; 14] in groups 1 and 3, respectively (p&gt;0.05). Initially, after 3 and 6 months at the peak of physical activity in groups 1 and 3, there was no decrease in arterial blood oxygen saturation according to pulse oximetry (SpO2) &lt;93 %. At baseline, lactate levels in central venous blood at rest were normal in all groups. After 6 months, the lactate concentration was 1.1 mmol / l in group 1, 2.3 mmol / l in group 2, and 1.4 mmol / l in group 3 (р1-2=0.005; p2-3=0.008, respectively). At the E peak at baseline, after 3 and 6 months, comparable increases in lactate not exceeding 3 mmol / l were detected in groups 1 and 3.Conclusion The study allowed assessment of the tolerability of individualized PRP performed at the aerobic level of energy supply, in inotropic-dependent patients with CHF. Individualized 6-month PRP in inotropic-dependent patients with end-stage CHF, provided safety criteria are met, is well tolerated and does not increase the number of AEs associated with CHF and physical rehabilitation (PR). Continued inotropic support with dopamine or dobutamine should not be considered as a contraindication to PR in patients with CHF in the absence of E intolerance or life-threatening AEs.

The lactate response to a second bout of exercise is not reduced in a concurrent lower-limb exercise program

We aimed to evaluate the blood lactate level in response to two bouts of exercise. First, we hypothesized that blood lactate elevation in response to moderate-intensity aerobic exercise (MIAE) would be lower at the end of the second bout of MIAE than the first bout of MIAE. In this context, we also hypothesized that lactate accumulation at the end of resistance exercise (RE) would be reduced if MIAE is performed before RE (i.e., concurrent exercise; CE). If so, we hypothesized that the order of the CE (i.e., RE + MIAE vs. MIAE + RE) influences blood lactate kinetics. To test the hypotheses, forty-three healthy men participated in three studies. In study 1, 20 men (age 21 ± 2 years) performed two bouts of a 20-min MIAE separated by a 20-min rest interval. In study 2, 11 men (age 22 ± 1 years) performed RE only and CE (MIAE + RE; ARCE) with a 20-min rest interval in a crossover design. In study 3, 12 men (age 21 ± 2 years) performed both CEs, which were ARCE and RE + MIAE (RACE), with a 20-min rest interval in a crossover design. We measured blood lactate before and at the end of each exercise session. In study 1, the blood lactate response to the second bout of MIAE was lower than that of the first bout (P < 0.001, r = 0.68). However, the blood lactate response to the ARCE trial was not lower than the response to the RE trial in study 2 (P = 0.475, r = 0.22). The results of study 3 showed that the RACE and ARCE trials induced a similar lactate response (MIAE P = 0.423, r = 0.28; RE P = 0.766, d = 0.03). These observations indicate that whereas lactate accumulation might be diminished by a second bout of MIAE, a different type of exercise (i.e., aerobic/resistance) did not result in a diminished lactate accumulation in response to a second bout of exercise.

Blood Lactate and Heart Rate Responses Between Active and Passive Recovery Modes Over a 15-Minute Recovery Period in Female Dancers After Kathak Dance.

Introduction: Dance is physically demanding and results in blood lactate (BL) accumulation and elevated Heart Rate (HR). Researchers recommend using either Active Recovery (AR; eg, low-to-moderate intensity-exercise) or Passive Recovery (PR; eg, complete rest) modes after activity. We compared BL and HR responses between AR or PR over a 15-minute recovery period following a Kathak dance. Methods: Twelve female dancers (31.0 ± 6.0 years; 161.5 ± 4.9 cm; 55.5 ± 5.8 kg) performed 2 dance testing sessions (Day 1 = AR, Day 2 = PR) 48 hours apart. Each session started with a 10-minute warm up followed by dancers performing four 2-minute stages of Kathak dance, with three 1-minute periods between stages where we recorded HR and their Rate of Perceived Exertion (RPE:scale = 6-20) to match the intensity of both sessions. Post-dance, we recorded dancers' BL and HR at 1, 3, 5, 10, and 15 minutes while they recovered via AR or PR. Separate 2(mode) × (time) Repeated-Measures-ANOVA followed by simple-main-effects testing and adjusted Bonferroni-pairwise-comparisons examined differences in BL and HR responses across modes and time(α = .05). Results: Dancers' HR and RPE were similar across sessions. No mode × time interaction existed in BL (F4,8 = 3.6, P = .06). BL levels were similar across modes (F1,2 = 0.5, P = .5). BL levels reduced over time (F4,8 = 6.0, P = .02), but Bonferroni-comparisons did not reveal any pairwise differences. In HR a significant mode*time interaction (F4,36 = 11.0, P = .01, η2 = .55) was observed. Both Active and Passive recovery modes achieved absolute HR levels by 15 minutes, with PR mode stabilizing within 5 minutes. Conclusions: Over a 15-minute recovery period after Kathak dance, dancers' BL and HR responses were similar across time in both AR and PR, with HR being higher in AR. Dancers' HR remained similar from 1 to 3 minute post dance recovery and then dropped over time. Thus, dancers can rest up to 3 minutes and still maintain the same elevated HR. Overall, dancers can choose either AR or PR as their recovery mode based on their individual preferences.

Diving into Recovery. The Effects of Different Post-Competition Protocols for Enhancing Physio-Psychological Parameters in National Level Youth Swimmers.

The purpose of this study was to elucidate whether a specific approach regarding active swimming recovery could better promote psycho-physiological recovery right after competing in a high-level swimming race. To achieve this, we recruited 50 national level youth swimmers, randomly and equally assigning them to two groups, named "experimental" and "coach prescribed". Each group performed a specific post-competition recovery protocol, consisting of different swimming paces, rest times, self-management of the exercises. We gathered data about blood lactate (BL), heart rate (HR), and rate of perceived exertion (RPE) at two different moments, the first moment right after the swimming competition (named post-competition phase), the second moment right after swimming the respective recovery protocol assigned (named post-recovery phase). A mixed MANOVA with Tukey HSD post-hoc analysis revealed no significant differences between the experimental and coach-prescribed groups in BL, HR, and RPE at the post-competition phase. At the post-recovery phase, however, the experimental group presented lower BL levels than the coach-prescribed group (2.40 ± 1.18 vs. 4.29 ± 2.07 mmol/L, p < 0.05). Finally, we found no interaction of swimming race ranking on recovery capacities. We conclude that for immediate improvement of BL in a wide range of high-level swimmers, an efficient recovery protocol should consist of several paces, high volumes, fixed and short rest times, whereas the widely popular self-managed, lower intensity approach does not seem as equally effective. Our study advances the development of novel recommendations for optimizing immediate fatigue management in competitive swimming.

Cognitive Improvement through Breathing Exercises in Post-Stroke Respiratory Sarcopenia: A Review

PURPOSE: The first purpose of this study is to investigate the relationship between Post-Stroke Respiratory Sarcopenia (PSRS) and Cognitive Impairment (CI) through Breathing Exercise (BE) as a respiratory rehabilitation after stroke (ST). The second purpose is to introduce a pilot study design set to investigate and compare the acute effects of each BE to develop a BE protocol for further studies.METHODS: Pubmed, Scopus, Web of Science and Google Scholar search engines were used to identify the definition and mechanism of ST, CI and respiratory sarcopenia (RS), and to find cases of application of BE in such conditions.RESULTS: Review; BEs that improve ST, RS, and CI symptoms are Box Breathing (Tactical Breathing), Fast-Breathing, Slow-paced Breathing, Inspiratory Diaphragmatic Breathing+Expiratory Pursed-lip Breathing Exercise. However, the effect is still unclear as post-stroke patients undergo multiple medical treatments other than BE. Pilot Study Prospective results; Inspiratory Diaphragmatic Breathing+Expiratory Pursed-lip Breathing Exercise, Slow-paced Breathing, Box Breathing (Tactical Breathing) and Fast-Breathing will be performed by 40 healthy college students through a randomized controlled trial for 4 weeks. Respiratory functions, exercise intensity, active oxygen level, blood lactate level, cerebral oxygen saturation and cognitive function will be measured pre- and post-intervention along with acute and 2 week mid-intervention. BEs are expected to improve respiratory function, cognitive performance and energy levels while reducing HR, BP, and stress. However, individual response to BE may vary according to health, physical fitness and life styles. All BE will be conducted in an evenly controlled and supervised environment for accurate data collection.CONCLUSIONS: Further study will be done to develop an appropriate BE protocol for PSRS patients per this review. Follow-up studies may also use this review as a reference for the application of BEs in PSRS patients with CI.