A simple and portable breathing circuit designed for ventilatory muscle endurance training (VMET)

Background: Ventilatory muscle endurance training (VMET) involves increasing minute ventilation (VE) against a tow flow resistance at rest to simulate the hyperpnea of exercise. Ideally, VMET must maintain normocapnia over a wide range Of VE. This can be achieved by providing a constant fresh gas flow to a sequential. rebreathing circuit. The challenge to make VMET suitable for home use is to provide a source of constant fresh gas flow to the circuit without resorting to compressed gas. Methods: Our VMET circuit was based on a commercial sequential gas delivery breathing circuit (Pulmanex Hi-Ox, Viasys Healthcare, Yorba Linda, CA USA). Airflow was provided either by a small battery-driven aquarium air pump or by the entrainment of air down a pressure gradient created by the recoil of a hanging bellows that was charged during each inhalation. In each case, fresh gas flow was adjusted to be just less than resting V-E. Eight subjects then breathed from the circuit for three 10 min periods consisting of relaxed breathing, breathing at 20 and then at 40 L/min. We monitored VE, end-tidal PCO2 (PETCO2) and hemoglobin O-2. saturation (SpO(2)). Results: During hyperpnea at 20 and 40 L/min, PETCO2 did not differ significantly from resting levels with either method of supplying fresh gas. SPO2 remained greater than 96% during all tests. Conclusion: Isocapnic VMET can be reliably accomplished with a simple self-regulating, sequential rebreathing circuit without the use of compressed gas. (C) 2009 Elsevier Ltd. All rights reserved.