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01-12-2005 | original Article

Ventilatory changes following head-up tilt and standing in healthy subjects

Authors: Angela T. Chang, Robert J. Boots, Michael G. Brown, Jennifer D. Paratz, Paul W. Hodges

Published in: European Journal of Applied Physiology | Issue 5-6/2005

Abstract

Passive tilting increases ventilation in healthy subjects; however, controversy surrounds the proposed mechanism. This study is aimed to evaluate the possible mechanism for changes to ventilation following passive head-up tilt (HUT) and active standing by comparison of a range of ventilatory, metabolic and mechanical parameters. Ventilatory parameters (V _T, V _E, V _E/VO₂, V _E/VCO₂, f and PetCO₂), functional residual capacity (FRC), respiratory mechanics with impulse oscillometry; oxygen consumption (VO₂) and carbon dioxide production (VCO₂) were measured in 20 healthy male subjects whilst supine, following HUT to 70° and unsupported standing. Data were analysed using a linear mixed model. HUT to 70° from supine increased minute ventilation (V _E) (P<0.001), tidal volume (V _T) (P=0.001), ventilatory equivalent for O₂ (V _E/VO₂) (P=0.020) and the ventilatory equivalent for CO₂ (V _E/VCO₂) (P<0.001) with no change in f (P=0.488). HUT also increased FRC (P<0.001) and respiratory system reactance (X5Hz) (P<0.001) with reduced respiratory system resistance (R5Hz) (P=0.004) and end-tidal carbon dioxide (PetCO₂) (P<0.001) compared to supine. Standing increased V _E (P<0.001), V _T (P<0.001) and V _E/VCO₂ (P=0.020) with no change in respiratory rate (f) (P=0.065), V _E/VO₂ (P=0.543). Similar changes in FRC (P<0.001), R5Hz (P=0.013), X5Hz (P<0.001) and PetCO₂ (P<0.001) compared to HUT were found. In contrast to HUT, standing increased VO₂ (P=0.002) and VCO₂ (P=0.048). The greater increase in V _E in standing compared to HUT appears to be related to increased VO₂ and VCO₂ associated with increased muscle activity in the unsupported standing position. This has implications for exercise prescription and rehabilitation of critically ill patients who have reduced cardiovascular and respiratory reserve.

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Title: Ventilatory changes following head-up tilt and standing in healthy subjects
Authors: Angela T. Chang
Robert J. Boots
Michael G. Brown
Jennifer D. Paratz
Paul W. Hodges
Publication date: 01-12-2005
Publisher: Springer-Verlag
Published in: European Journal of Applied Physiology / Issue 5-6/2005
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-005-0019-2

At a glance: The STEP trials

Springer Medicine

Ventilatory changes following head-up tilt and standing in healthy subjects

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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