Work of breathing is increased during exercise with the self-contained breathing apparatus regulator

Abstract

The self-contained breathing apparatus (SCBA) increases the expiratory pressure required to maintain high rates of ventilation, suggesting that the expiratory work of breathing (WOB) is increased; however, this has never been reported. The objective of this study, therefore, was to determine if the WOB is increased with the SCBA regulator (BA condition) compared with a low-resistance breathing valve (RV condition) during exercise. Twelve healthy male subjects underwent two randomized exercise trials, consisting of cycling at 150, 180, 210, and 240 W. Inspired and expired tidal volumes were measured using a body plethysmograph, whereas esophageal pressures were measured with an esophageal balloon. Modified Campbell diagrams were created to calculate the resistive and elastic components of WOB during inspiration and expiration. There were no differences in WOB between BA and RV conditions at 150 W. End-inspiratory and -expiratory lung volumes were elevated (p < 0.05) in the BA condition at higher ventilation rates, which increased inspiratory elastic work and decreased expiratory elastic work at 180 and 210 W (p < 0.05). At 240 W (VE = 112 ± 17 L·min–1 in the BA condition), active expiratory resistive work increased by 59% ± 51%, inspiratory elastic work increased by 26% ± 24%, and total WOB increased by 13% ± 12% in the BA condition (p < 0.05). The SCBA regulator causes an increase in the active expiratory resistive work to maintain high ventilatory rates and an increase inspiratory elastic work through an elevation in lung volumes.