Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics

Grzegorz Bilo, Miriam Revera, Maurizio Bussotti, Daniele Bonacina, Katarzyna Styczkiewicz, Gianluca Caldara, Alessia Giglio, Andrea Faini, Andrea Giuliano, Carolina Lombardi, Kalina Kawecka-Jaszcz, Giuseppe Mancia, Piergiuseppe Agostoni, Gianfranco Parati, Grzegorz Bilo, Miriam Revera, Maurizio Bussotti, Daniele Bonacina, Katarzyna Styczkiewicz, Gianluca Caldara, Alessia Giglio, Andrea Faini, Andrea Giuliano, Carolina Lombardi, Kalina Kawecka-Jaszcz, Giuseppe Mancia, Piergiuseppe Agostoni, Gianfranco Parati

Abstract

Slow deep breathing improves blood oxygenation (Sp(O2)) and affects hemodynamics in hypoxic patients. We investigated the ventilatory and hemodynamic effects of slow deep breathing in normal subjects at high altitude. We collected data in healthy lowlanders staying either at 4559 m for 2-3 days (Study A; N = 39) or at 5400 m for 12-16 days (Study B; N = 28). Study variables, including Sp(O2) and systemic and pulmonary arterial pressure, were assessed before, during and after 15 minutes of breathing at 6 breaths/min. At the end of slow breathing, an increase in Sp(O2) (Study A: from 80.2±7.7% to 89.5±8.2%; Study B: from 81.0±4.2% to 88.6±4.5; both p<0.001) and significant reductions in systemic and pulmonary arterial pressure occurred. This was associated with increased tidal volume and no changes in minute ventilation or pulmonary CO diffusion. Slow deep breathing improves ventilation efficiency for oxygen as shown by blood oxygenation increase, and it reduces systemic and pulmonary blood pressure at high altitude but does not change pulmonary gas diffusion.

Conflict of interest statement

Competing Interests: The authors have the following interests. Study B was supported with an unrestricted grant from Boehringer-Ingelheim Germany and Banca Intesa San Paolo, Milan, Italy. Sapio Life Italy s.r.l., GE Healthcare, and Intercure Ltd. supplied the devices necessary for this study free of charge. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1. Schematic representation of the sequence…
Figure 1. Schematic representation of the sequence of data collection in studies A and B.
SpO2, blood oxygen saturation; PtO2, transcutaneous oxygen partial pressure; PtCO2, transcutaneous CO2 partial pressure; HR, heart rate; BP, blood pressure; RF, respiratory frequency; PAP, pulmonary artery pressure; Vt, tidal volume; VE, minute ventilation; Dl CO, pulmonary CO diffusion; VA = alveolar volume; TFC, thoracic fluid content; Pet CO2, end tidal CO2 pressure in the exhaled air.
Figure 2. Changes in Sp O2 (upper…
Figure 2. Changes in SpO2 (upper panel), PtO2 (middle panel) and PtCO2 (lower panel) during slow breathing exercise and recovery.
Differences vs. baseline with p

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