Cord blood and serial lactate levels in predicting short-term outcome in term new-born babies with perinatal asphyxia

Introduction: Birth asphyxia is a leading cause of neonatal deaths across the globe. Clinical examination, Apgar score, pH, EEG/aEEG, Lactate are being used as markers for prediction of outcome. Serum Lactate is a better reflector of metabolic mechanism. We intend to study cord blood lactate and serial lactate levels in term birth asphyxia babies. Aim: To determine correlation between cord blood lactate, serial lactate levels and short term outcome in term new-born babies with perinatal asphyxia. Materials and Methods: It was a prospective, observational study. Thirty term babies with birth asphyxia were selected. Their Cord blood lactate, serum lactate at 6, 12, 24 hours of life were correlated to short term outcomes (NICU stay, shock, Acute kidney injury, mortality). Results: Eighteen babies with moderate asphyxia and 12 with severe asphyxia had mean cord blood lactate of 10.4mmol/L and 13.47mmol/L respectively. There was difference in mean lactate levels at 6, 12, 24 hours of life between the babies who survived and expired; also survivors had significant reduction in mean lactate levels at various time points. Babies with moderate asphyxia had no shock and AKI. Babies with severe asphyxia and shock had mean lactate levels of 12mmol/L in survivors and 13.8mmol/L in who expired. Babies with severe asphyxia and AKI had mean lactate of 14mmol/L in survivors and 14.6mmol/L in who expired. Babies with moderate asphyxia had no mortality. In babies with severe asphyxia, survivors had mean lactate of 12.74mmol/L and 14mmol/L in babies who expired. There was no correlation between the lactate levels and the length of the NICU stay. Conclusion: Serial lactate levels can be used to predictor the short term prognosis in term babies with perinatal asphyxia. There was significant difference in mean lactate levels between the babies who survived and expired. Serial lactate levels showed significant reduction in babies who survived.

Differences between genders in anaerobic capacity during a supramaximal effort

Aim: The present study aimed to verify if there is a difference between genders in anaerobic capacity estimated by energetic equivalents of glycolytic and phosphagen pathways (AC[La-]+EPOCfast). Methods: In this way, 8 men and 8 women (physical education students) were subjected to the following sequence of tests: session 1) graded exercise test to measure the maximal oxygen consumption (VÖ½ O2max) and intensity associated with VÖ½ O2max (iVÖ½ O2max); sessions 2 to 3) familiarization with supramaximal effort at 115% of iVÖ½ O2max; session 4) supramaximal effort at 115% of iVÖ½ O2max to measure AC[La-]+EPOCfast. Results: The AC[La-]+EPOCfast was lower in women compared to men when expressed in absolute and relative values (-38.11%; p=0.01 and -25.71%; p=0.03, respectively). A non-significant difference was observed in performance in the supramaximal effort (-12.08%; p=0.15), besides which, a likely negative inference was observed when comparing women to men. In addition, energetic equivalents of the glycolytic pathway (e[La- ]) were also lower in women when expressed in relative and absolute values (-47.01%; p=0.001 and -36.71%; p=0.001, respectively), however no statistical difference was found for energetic equivalents of the phosphagen pathway (ePCr) (p>0.05). Conclusion: The AC[La-]+EPOCfast is lower in women compared to men, mainly due to differences in the glycolytic pathway.(AU)

Exercício de força combinado à restrição de fluxo sanguíneo induz aumentos agudos na pressão arterial sistólica / Strength exercise combined to blood flow restriction induces acute increases in systolic blood pressure

Recentemente cresceu o número de pesquisas sobre o exercício de força (EF) de baixa intensidade (20-50% de 1RM) combinado à restrição do fluxo sanguíneo (RFS), mostrando adaptações semelhantes ao EF de alta intensidade. Entretanto, muitas questões sobre essa metodologia necessitam ser investigadas. O objetivo desse estudo foi analisar a resposta aguda da pressão arterial em repouso e durante o EF combinado à RFS. Dezesseis jovens (22±2 anos de idade), ativos e de ambos os sexos, realizaram o EF em duas diferentes condições, separadas por um intervalo de 48h: 1) Exercício isolado (EF) e 2) Exercício combinado à RFS (EF+RFS, 100 mmHg, porção proximal da coxa, mantida durante o exercício). Ambos realizaram 3 séries no exercício leg press com o membro dominante, à 30% de 1RM, 1 minuto de descanso, duração de 90 segundos cada série e cadência de 2 segundos, totalizando 22 repetições para a fase concêntrica e 23 para a fase excêntrica do movimento. Foram avaliadas a pressão arterial sistólica (PAS), diastólica (PAD), frequência cardíaca (FC), duplo produto (DP) e lactato sanguíneo nos momentos: repouso e imediatamente após o exercício. Foi observado apenas aumento significativo da PAS e do DP em repouso e da PAS durante o EF+RFS. O lactato sanguíneo não se alterou em nenhuma condição avaliada. Concluindo que o exercício de força com restrição de fluxo sanguíneo apresentou maiores respostas de pressão arterial sistólica em repouso e durante o exercício em sujeitos jovens ativos...(AU)

Recently, the number of researches about the strength exercise (SE) of low intensity (20- 50% of 1RM) combined to the blood flow restriction (BFR) increased, showing similar adaptations to the high-intensity SE. However, many questions about this methodology need be investigated. The purpose of this study was to analyze the acute response of blood pressure at rest and during SE combined with BFR. Sixteen young subjects (22 ± 2 years old), actives and of both sexs, underwent SE in two different conditions, separated by an interval of 48h: 1) isolated strength exercise (SE) and 2) strength exercise combined to BFR (SE+BFR, 100 mmHg, proximal portion of the thigh, maintained throughout the exercise session). Both conditions performed 3 sets on the leg press exercise with the dominant leg, with 30% of 1RM, 1 minute of rest, each series with 90 seconds of the duration and movement cadence of the 2 seconds, totaling 22 repetitions in the concentric phase and 23 in the eccentric phase of movement. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), double product (DP) and blood lactate were evaluated on rest and immediately after exercise moments. It was observed only significant increase in SBP and DP at rest and SBP during SE+BFR condition. Blood lactate did not change in any condition evaluated. Concluding that strength exercise with blood flow restriction showed higher responses of systolic blood pressure at rest and during exercise in active young subjects...(AU)

Blood lactate increases with the progression of mitral valve disease in dogs / Aumento de lactato sanguíneo com progressão de valvopatia mitral em cães

In dogs with congestive heart failure, the upregulated sympathetic tone causes vasoconstriction that impairs peripheral blood supply, therefore causing the accumulation of lactate. In this prospective cross-sectional study with a longitudinal component, blood lactate was quantified in 10 healthy and 34 myxomatous mitral valve disease (MMVD) dogs to investigate its potential use as a diagnostic and prognostic biomarker. While there were no differences in lactate concentration between control animals and stages B1 (3.31±0.62mmol/L) and B2 (3.32±0.46mmol/L) dogs, significant differences were found between healthy (2.50±0.69mmol/L) and both C (3.99±0.47mmol/L) and D (6.97±1.23mmol/L) animals. When a cut-off of 3.35mmol/L was used, lactate was able to distinguish dogs with normal and remodeled hearts with a sensitivity of 78.2% and specificity of 63.6%. Also, significant correlations existed between lactate and indicators of cardiac remodeling. Finally, animals with blood lactate <3.5mmol/L carried a better prognosis when compared with dogs in which lactate was >5.0mmol/L. Our results suggest that the progression of MMVD results in accumulation of lactate within the bloodstream, which is likely attributable to the impaired peripheral tissue perfusion. In MMVD dogs, blood lactate may be used as a surrogate for cardiac remodeling, and an increased concentration is associated with a worse prognosis regarding the time to evolve into congestive heart failure.(AU)

Em cães com insuficiência cardíaca congestiva, o tônus simpático hiperregulado causa vasoconstrição e interfere com o suprimento sanguíneo periférico, resultando no acúmulo de lactato. Neste estudo prospectivo transversal com um componente longitudinal, o lactato sanguíneo foi quantificado em 10 cães saudáveis e 34 cães com doença mixomatosa da valva mitral (DMVM) para investigar seu potencial como biomarcador diagnóstico e prognóstico. Embora não tenham sido identificadas diferenças na concentração de lactato entre animais controle e cães com DMVM nos estágios B1 (3,31±0,62mmol/L) e B2 (3,32±0,46mmol/L), diferenças significativas foram constatadas entre os cães saudáveis (2,50±0,69mmol/L) e cães com DMVM estágio C (3,99±0,47mmol/L) ou D (6,97±1,23mmol/L). Quando utilizado o valor de corte de 3,35mmol/L, o lactato foi capaz de diferenciar cães com corações normais daqueles com corações remodelados com sensibilidade de 78,2% e especificidade de 63,6%. Além disso, correlações significativas foram encontradas entre o lactato e os indicadores de remodelamento cardíaco. Por fim, os animais com lactato sanguíneo <3,5mmol/L tiveram prognóstico melhor comparativamente aos cães com concentrações >5,0mmol/L. Nossos resultados sugerem que a progressão da DMVM resulta no acúmulo de lactato na corrente sanguínea, fato que é provavelmente atribuído à perfusão periférica prejudicada. Em cães com DMVM, o lactato sanguíneo pode ser utilizado como indicador de remodelamento cardíaco, cuja concentração elevada está associada com pior prognóstico relativo ao tempo para evoluir para insuficiência cardíaca congestiva.(AU)

Effects of NT-proBNP,blood lactate levels,troponin I and plasma cystatin C on the prognosis of patients undergoing cardiopulmonary bypass / 实用医学杂志

Objective To explore the relationship between multiple serological indexes and cardiac prog-nosis risk of patients;To compare the four predictive value of prognosis of patients with cardiac surgery. Meth-ods A total of 127 patients treated by cardiopulmonary bypass surgery were enrolled from July 2013 to March 2015 in our department.Their baseline data were recorded.All patients were followed up for 2 years.Patients with adverse outcomes were defined as the unfavorableprognosis group during the follow-up period while the patients with nodisease progression were defined as the favorableprognosis group. Univariate analysis and Cox proportional risk model wereapplied to evaluate the effects of all factors on the patient's prognosis. Meanwhile,the prediction ability of multiple serological indexes in predicting prognosis of patients with cardiac surgery was calculated by ROC curve analysis. Results Multivariate Cox proportional hazard model showed that the △NT-proBNP(P =0.019),△plasma levels of cystatin C(P=0.037),△troponin I(P=0.028)and LVEF(P=0.045)have signifi-cant influence on the prognosis of the patients and the △NT-proBNP has the highest degree(RR = 1.598);The AUC of the NT-proBNP combined with LVEF in diagnosis of patients with cardiac surgery was 0.842,and the sen-sitivity and specificity were 75.3% and 76.2%,respectively. Conclusions The level of △NT-proBNP and LVEF have a good predictive ability for cardiac outcome in patients undergoing surgery,which is expected as a conven-tional evaluation index of cardiac surgery with cardiopulmonary bypass.

Combination of blood lactate level with assessment of blood consumption (ABC) scoring system: A more accurate predictor of massive transfusion requirement / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Exsanguination is the most common leading cause of death in trauma patients. The massive transfusion (MT) protocol may influence therapeutic strategies and help provide blood components in timely manner. The assessment of blood consumption (ABC) score is a popular MT protocol but has low predictability. The lactate level is a good parameter to reflect poor tissue perfusion or shock states that can guide the management. This study aimed to modify the ABC scoring system by adding the lactate level for better prediction of MT.</p><p><b>METHODS</b>The data were retrospectively collected from 165 trauma patients following the trauma activated criteria at Songklanagarind Hospital from January 2014 to December 2014. The ABC scoring system was applied in all patients. The patients who had an ABC score ≥2 as the cut point for MT were defined as the ABC group. All patients who had a score ≥2 with a lactate level >4 mmol/dL were defined as the ABC plus lactate level (ABC + L) group. The prediction for the requirement of massive blood transfusion was compared between the ABC and ABC + L groups. The ability of ABC and ABC + L groups to predict MT was estimated by the area under the receiver operating characteristic curve (AUROC).</p><p><b>RESULTS</b>Among 165 patients, 15 patients (9%) required massive blood transfusion. There were no significant differences in age, gender, mechanism of injury or initial vital signs between the MT group and the non-MT group. The group that required MT had a higher Injury Severity Score and mortality. The sensitivity and specificity of the ABC scoring system in our institution were low (81%, 34%, AUC 0.573). The sensitivity and specificity were significantly better in the ABC + L group (92%, 42%, AUC = 0.745).</p><p><b>CONCLUSION</b>The ABC scoring system plus lactate increased the sensitivity and specificity compared with the ABC scoring system alone.</p>

Effect of resistance exercise with different muscle action durations on lactate response / Efeito de protocolos de treinamento com diferentes durações das ações musculares na concentração de lactato sanguíneo

ABSTRACT The aim of this study was to compare the blood lactate concentration in strength training protocols with different muscle action durations in the bench press exercise. Seventeen volunteers performed three protocols with three sets of six repetitions at 60 % of 1RM, three- minute break between sets and different muscle action durations (2-4: 2s concentric and 4s eccentric; 3-3: 3s concentric and 3s eccentric; 4-2: 4s concentric and 2s eccentric). The analysis of blood lactate concentration considered the average values ​​per set in each protocol. The ANOVA two-way of the results showed that the main effect for protocol showed no significant difference between the three protocols (F = 0,75; p = 0,48; power = 0,48; η2 = 0,17), as the interaction among the factors (F = 1,68; p = 0,13; power = 0,09; η2= 0,62). However, there was significant main effect for set (F = 320,23; p = 0,0001; power = 1,00; η2= 0,95). Therefore, resistance training protocols equated with different muscle actions durations shows no differences in blood lactate response and, regardless of the protocol, its concentration increased throughout the three sets performed.

RESUMO O objetivo deste estudo foi comparar a concentração de lactato sanguíneo em protocolos de treinamento de força com diferentes durações das ações musculares no exercício supino. Dezessete voluntários executaram três protocolos com três séries de seis repetições a 60% de 1RM, pausa de três minutos entre as séries e diferentes durações das ações musculares (2-4: 2s concêntrica e 4s excêntrica; 3-3: 3s concêntrica e 3s excêntrica; 4-2: 4s concêntrica e 2s excêntrica). A análise da concentração de lactato sanguíneo considerou os valores médios por série em cada protocolo. Os resultados da ANOVA two-way mostraram que o efeito principal protocolo não apresentou diferença significante entre os três protocolos (F = 0,75; p = 0,48; poder = 0,48; η2 = 0,17), assim como para a interação entre os fatores (F = 1,68; p = 0,13; poder = 0,09; η2 = 0,62). Porém, houve diferença significante na concentração de lactato sanguíneo para o fator série (F = 320,23; p = 0,0001; poder = 1,00; η2 = 0,95). Portanto, protocolos de treinamento de força equiparados com durações das ações musculares distintas não apresentaram diferenças na resposta do lactato sanguíneo e, independentemente do protocolo, a concentração deste substrato aumentou ao longo das três séries realizadas.

A study of the blood hypoxia inducible factor 1α and the lactate and lactate clearance in patients with septic shock / 实用医学杂志

Objective To investigate the significance of hypoxia inducible factor lα and lactate and lactate clearance in patients with septic shock.Methods A prospective observational study was conducted.Thirty healthy volunteers (control group) and 40 cases of septic shock patients in EICU were recruited.According to the survival time,40 patients with septic shock were divided into survival group (21 cases,survival time ＞ 28 days) and death group (19 cases,survival time ≤ 28 d).The HIF-lα level was tested by ELISA assay.Lactate level of 0,6,12,24 h in arterial blood were also tested.Lactate clearance rate of the 6 h,12 h and 24 h were calculated.The association of HIF-1α and lactate level and lactate clearance rate,APACHE Ⅱ score and prognosis were evaluated.Results 40 patients with septic shock,20 male and 20 femnales,the mean age was (61.3 ± 12.8) years.The 28 day mortality rate was 47.5％.The average APACHE Ⅱ score was (23.7 ± 4.83) and arterial blood lactate levels was (5.88 ± 2.73) mmol/L.In death group and survival group,the levels of HIF-1α levels and blood lactate were significantly higher than that in the control group (P ＜ 0.05).The death group increased more significantly (P ＜ 0.05).In death group,the 6 h,12 h and 24 h lactate clearance rate were lower than the survival group (all P ＜ 0.01).APACHE Ⅱ score were higher than that in survival group (P ＜ 0.05) and the difference is statistically significant.The lactate and HIF-1α were positively correlated (r =0.868,P ＜ 0.01).Blood lactate and HIF-1α levels were all positively correlated with APACHEⅡ score (r =0.804,P ＜ 0.01) and (r =0.811,P ＜ 0.01).Conclusion The level of HIF-1α,blood lactate,lactate clearance rate are closely related with the severity and prognosis of septic shock and may become an important indicator of the prognosis.

Relationship between blood lactate level and the prognosis of patients with diabetic sepsis / 中华危重病急救医学

Objective To evaluate the prognostic value of blood lactate (Lac) level in sepsis patients with or without diabetes.Methods 106 patients admitted to intensive care unit (ICU) of Zhongshan Hospital Affiliated to Fudan University from April 2015 to November 2016 were enrolled. The patients with age > 18 years and the length of hospital stay > 24 hours were included. Records including blood Lac, serum creatinine (SCr), white blood cell count (WBC), platelet count (PLT), sequential organ failure assessment (SOFA) on the first day of admission; minimum oxygen index (PaO2/FiO2) in 3 days after admission; mechanical ventilation, whether there was a history of diabetes, usage of biguanides, etiology control treatment, usage of continuous renal replacement therapy (CRRT) were collected. According to the level of blood Lac patients were divided into high Lac group (Lac > 2 mmol/L) and low Lac group (Lac ≤ 2 mmol/L);based on their diabetic history, sepsis patients were divided into the diabetes group and non-diabetes group. The survival curve of each group was analyzed by Kaplan-Meier regression analysis, and the factors influencing the prognosis were analyzed by multivariate Cox regression analysis.Results There were 76 males and 30 females sepsis patients, with an average age of (68.1±14.7) years old. In the 51 patients of low Lac group, there were 7 patients who suffered from diabetes. While in the 55 patients of high Lac group, there were 12 patients who suffered from diabetes. Compared with low Lac group, high Lac group had a higher age, higher SOFA score, and a lower proportion of patients who had the treatment of etiology control (allP 0.05). Kaplan-Meier survival curve analysis showed that the 90-day survival rate in the high Lac group was significantly lower than that in the low Lac group (56.36% vs. 90.20%,χ2 = 0.697,P = 0.008). The high Lac group without diabetes had lower survival rate, and the 90-day survival rate was significantly lower than that of the low Lac group without diabetes (58.14% vs. 90.90%,χ2 = 7.152,P = 0.007); there was no significant difference in 90-day survival rate between the high Lac group and the low Lac group with diabetes (50.00% vs. 85.71%,χ2 = 0.012,P = 0.914). Multivariate Cox regression analysis showed that blood Lac was an independent risk factor for the prognosis of sepsis patients [odds ratio (OR) = 3.863, 95% confidence interval (95%CI) = 1.237-12.060,P = 0.020]. After stratification according to their diabetic history, the blood Lac was an independent risk factor for the prognosis of sepsis patients without diabetes (OR = 4.816, 95%CI = 1.407-15.824, P = 0.010), but the blood Lac had no effect on the prognosis of sepsis patients with diabetes (OR = 0.000, 95%CI =0.000-1.103,P = 0.270).Conclusions The predictive value of blood Lac on sepsis patients with or without diabetes was different. The blood Lac was related with the prognosis of sepsis patients without diabetes, while further study should be conducted for the prognostic value of blood Lac in sepsis patients with diabetes, and it's possible to increase the cut-off-point of Lac level in these patients.

Trend of blood lactate level in acute aluminum phosphide poisoning / 世界急诊医学杂志（英文）

BACKGROUND:Aluminum phosphide (AlP) poisoning is common in the developing countries. There is no specific antidote for the treatment of acute AlP poisoning. Early diagnosis of poisoning and outcome predictors may facilitate treatment decisions. The objective of this study was to determine the trend of blood lactate level in acute AlP poisoning to evaluate its role as a prognostic factor. METHODS:This was a prospective study on acute AlP intoxicated patients during one year. Demographic data, clinical and laboratory data on admission, and outcome were recorded in a self-made questionnaire. Blood lactate levels were analyzed every two hours for 24 hours. RESULTS:Thirty-nine (27 male, 12 female) patients were included in the study. The mortality rate was 38.5％. The mean blood pressure, pulse rate, blood pH and serum bicarbonate level were significantly different between the survivors and non-survivors groups. Blood lactate level was significantly higher in the non-survivors group during 8 to 16 hours post ingestion. CONCLUSION:Blood lactate level could be used as an index of severity of acute AlP poisoning.

Study on correlation between mixed SvO2, P(v-a)CO2 and LAC with APACHEⅡ score, SOFA score and disease condition / 重庆医学

Objective To investigate the correlation between mixed venous oxygen saturation(SVO2),mixed venous-arterial partial pressure of carbon dioxide[P(v-a)CO2] and blood lactate(LAC) with the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score,and to investigate the value of SVO2,P(v-a)CO2,LAC in assessing the disease condition.Methods A total of 104 patients with heart operation in the Chengdu Municipal Third People's Hospital from December 2011 to March 2015 were collected and divide into survival group and non-survival group according to the prognosis.The correlation between SvO2,P(v-a)CO2 and LAC with the APACHE Ⅱ score and SOFA score was analyzed by using the Pearman correlation analysis.The correlation between SvO2,P(v-a)CO2 and LAC with the disease condition was also analyzed.The Receiver Operating Characteristic (ROC) curvewas utilized to evaluating the accuracy of SvO2,P(v-a)CO2 and LAC for assessing the prognosis.Results Compared with the survival group,the difference of P(v-a)CO2,LAC,APACHE Ⅱ scores in the non-survival group had statistical significance(P＜0.05).SOFA score was 11.22 vs.7.35 (t=-3.433,P＜0.01),all were significantly increased,but SvO2 was significantly decreased(0.65 vs.0.71,t=2.794,P＜0.05).The values of SvO2 and LAC were significantly correlated with SOFA score (r=-0.268,P=0.006;r=0.200,P =0.041).But P(v-a) CO2 had no correlation with SOFA score(r=0.190,P=0.054).The values of SvO2,P(v-a)CO2 and LAC were correlated with APACHE Ⅱ score(r=-0.3,76,P=0.000;r=0.282,P=0.004;r=0.264,P =0.007).The values of SvO2,P (v-a) CO2 and LAC were correlated with prognosis (r=0.308,P=0.001;r=-0.248,P=0.011;r=-0.400,P=0.000).The areas under ROC curve of SvO2,P(v-a)CO2 and LAC corresponding practical mortality all were less than 0.70.Conclusion SvO2,P(v-a)CO2 and LAC have a certain correlation with the APACHE Ⅱ score,SOFA score and severity of disease condition,but which can not serve as the evaluation indicators of prognosis.

Effects of CBP on blood lactate and hemodynamics in patients with severe sepsis / 中国生化药物杂志

Objective To explore the treatment of sepsis in patients with severe sepsis, the use of CBP (continuous blood purification) effect on lactic acid and hemodynamics in patients with blood.MethodsIn 40 cases of patients with severe sepsis treated by conventional methods, and classified as the control group, the other 40 patients using CBP (continuous blood purification treatment;blood lactic acid) after evaluation and hemodynamics of two groups of patients before and after treatment, and compared between groups, the patients were treated in our hospital from January 2015 to October 2016.ResultsThere was no significant difference in blood lactate level of the two groups of patients before treatment, after grouping After treatment, the patients in the observation group decreased more significantly, while the monitoring of patients in different time period, showed its obvious difference;hemodynamics of two groups were observed and compared, found before treatment all indexes had no significant difference after the treatment group were improved more obviously in patients in the observation group, group are P<0.05 shows obvious differences.ConclusionAnalysis of the influence of the dynamics of CBP in severe sepsis patients blood lactic acid and blood flow, which can significantly improve the patient's level of lactic acid, which decreased gradually, while helping the hemodynamic situation of the patient to recover, it is worthy of reference.

Lactato sanguíneo e percepção subjetiva de esforço em luta simulada por atletas de MMA / Blood lactate and rate of perceived exertion responses of MMA athletes competing in a simulated match / Lactato sanguíneo y percepción subjetiva de esfuerzo en lucha simulada para deportistas de MMA

Seis atletas de MMA com peso de 74,3 kg realizaram três rounds (R) de cinco minutos de combate, sendo avaliado o lactato (LA) em repouso, após o término de cada R (1º e 2º), após o término do último R, cinco e sete minutos após o término da luta. A Percepção Subjetiva do Esforço (PSE) foi avaliada após o fim do combate. Durante as lutas de MMA, eles utilizam inúmeras ações de energia glicolítica, sugerindo que as vias anaeróbias são utilizadas pelos atletas durante o combate. Com LA em repouso de 2,6 ± 0,5 e obtendo valores de LA de 8, 3± 0,4 no 1º R, 10,5 ± 0,3 no 2º R, 11,7 ± 0,6 no 3º R, bem como de 12,7 ± 0,6 e 11,5 ± 1,1 no 5° e 7° minuto após o fim da luta, respectivamente. A PSE encontrada foi de 18,0 ± 0,9. Devido a valores altos de LA, bem como PSE, pode-se inferir que esta modalidade apresenta uma intensidade e dificuldade extremamente elevada.

Six MMA athletes weighing 74,3kg performed 3 rounds (R) of 5 minutes of combat, having the blood lactate (LA) evaluated 5 times: during the rest after the end of each R (1st and 2nd), after the last R, and on the 5th and 7th minutes after the fight. The Perceived Exertion Responses Rate (PERR) was assessed after the end of the combat. During MMA fights, they use high glycolytic energy stocks, suggesting that anaerobic pathways are used by athletes during combat. With LA during rest at 2.6 ± 0.5 and getting LA values of 8.3 ± 0.4 in the 1st R, 10.5 ± 0.3 in the 2nd R, 11.7 ± 0.6 in the 3rd R, and 12.7 ± 0.6 and 11.5 ± 1.1 at 5 and 7 minutes after the end of the fight respectively, the PERR found was 18.0 ± 0.9. Due to high levels of LA and PERR, it can be inferred that this modality is highly intense and extremely hard.

Seis atletas de MMA que pesan 74,3kg realizaron 3 rounds (R) 5 minutos de combate, siendo analizado el lactato (LA) en reposo, después del final de cada R (1º y 2º), después del último R, cinco y siete minutos después de haber terminado la lucha. La Percepción Subjetiva del Esfuerzo (PSE) se analizó después del final del combate. Durante las luchas de MMA, ellos usan innúmeras acciones de energía glucolíticas, lo que sugiere que las vías anaeróbicas son utilizados por los atletas durante el combate. Con LA en reposo 2.6 ± 0.5 y obteniendo valores de LA de 8,3 ± 0,4 en el 1º R, 10,5 ± 0,3 en el 2º R, 11,7 ± 0,6 en la 3ª R y 12,7 ± 0,6 y 11,5 ± 1,1 a los 5 y 7 minutos después del final de la lucha respectivamente. El PSE encontrado fue 18,0 ± 0,9. Debido a los altos niveles de LA, así como PES, se puede inferir que la modalidad presenta tiene intensidad y dificultad extremamente elevada.

Is heart rate variability a feasible method to determine anaerobic threshold in progressive resistance exercise in coronary artery disease?

ABSTRACT Background Recent studies have shown that the magnitude of the metabolic and autonomic responses during progressive resistance exercise (PRE) is associated with the determination of the anaerobic threshold (AT). AT is an important parameter to determine intensity in dynamic exercise. Objectives To investigate the metabolic and cardiac autonomic responses during dynamic resistance exercise in patients with Coronary Artery Disease (CAD). Method Twenty men (age = 63±7 years) with CAD [Left Ventricular Ejection Fraction (LVEF) = 60±10%] underwent a PRE protocol on a leg press until maximal exertion. The protocol began at 10% of One Repetition Maximum Test (1-RM), with subsequent increases of 10% until maximal exhaustion. Heart Rate Variability (HRV) indices from Poincaré plots (SD1, SD2, SD1/SD2) and time domain (rMSSD and RMSM), and blood lactate were determined at rest and during PRE. Results Significant alterations in HRV and blood lactate were observed starting at 30% of 1-RM (p<0.05). Bland-Altman plots revealed a consistent agreement between blood lactate threshold (LT) and rMSSD threshold (rMSSDT) and between LT and SD1 threshold (SD1T). Relative values of 1-RM in all LT, rMSSDT and SD1T did not differ (29%±5 vs 28%±5 vs 29%±5 Kg, respectively). Conclusion HRV during PRE could be a feasible noninvasive method of determining AT in CAD patients to plan intensities during cardiac rehabilitation.

Analysis of correlations between blood lactic acid, lactate clearance rate and emergency stratification as well as prognosis in patients / 中华危重病急救医学

Objective To investigate the correlations between the level of blood lactic acid (Lac),lactate clearance rate (LCR) and emergency stratification Ⅰ or Ⅱ as well as the prognosis in patients.Methods A retrospective analysis was conducted.The clinical data of 370 critically ill patients with emergency stratification Ⅰ or Ⅱ accompanying with hyperlactacidemia admitted to emergency center of People's Hospital of Wuwei City during January 2013 to April 2015 were analyzed.The patients were allocated into two groups:Lac ≥ 10 mmol/L (n =181) and Lac 4-10 mmol/L (n =189).Base excess (BE),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and hospital mortality were compared between the two groups.The differences in initial Lac,6-hour LCR and APACHE Ⅱ score were compared between survival group and death group as well as emergency stratification Ⅰ and Ⅱ groups.The correlation between initial Lac,6-hour LCR and APACHE]Ⅱ score was analyzed by Pearson correlation method.Results ① With the increase in Lac level,the negative deviation extent of BE and APACHE Ⅱ score in critical patients were gradually increased [BE (mmol/L):-16.74 ± 8.21 vs.-5.98 ± 8.43,APACHE Ⅱ score:27.6 ± 5.6 vs.20.1 ± 4.8],and hospital mortality was increased [76.79％ (139/181) vs.43.39％ (82/189),all P ＜ 0.01].② The initial Lac and APACHE Ⅱ score of the death group were significantly higher than those of the survival group [initial Lac (mmol/L):8.81 ± 4.71 vs.4.43 ± 2.82,APACHE Ⅱ score:23.6 ± 5.6 vs.17.3 ± 3.7],and 6-hour LCR was significantly decreased [(12.26 ± 6.47)％ vs.(35.16± 10.63)％,all P ＜ 0.01].③ Patients in emergency stratification Ⅰ group had a higher initial Lac and a higher APACHE Ⅱ score but a lower 6-hour LCR level than those in emergency stratification Ⅱ group [initial Lac (mmol/L):8.7±2.6 vs.6.8±2.0,APACHE Ⅱ score:25.2±6.3 vs.16.3±4.7,6-hour LCR:(14.8±4.7)％ vs.(33.5±5.8)％,both P ＜ 0.01].④ It was shown by correlation analysis that initial Lac was significantly positively correlated with APACHE Ⅱ score (r =0.731,P =0.017) in 370 emergency critical ill patients,while 6-hour LCR was negatively correlated with APACHE Ⅱ score (r =-0.694,P =0.010).Conclusions The early arterial blood Lac of patients with emergency stratification Ⅰ was significantly higher than emergency stratification Ⅱ,and the 6-hour LCR in patients with emergency stratification Ⅱ was significantly higher than emergency stratification Ⅰ.Furthermore,the Lac level and LCR were simple and easy to implement as compared with APACHE Ⅱ score in emergency critical ill patients.

Blood lactate minimum of rats during swimming test using three incremental stages / Lactato sanguíneo mínimo de ratos durante teste de natação usando três etapas incrementais / Lactato sanguíneo mínimo de ratas durante la prueba de natación con tres pasos incrementales

The purpose of this study was to determine the lactate minimum intensity (LMI) by swimming LACmintest using three incremental stages (LACmintest3) and to evaluate its sensitivity to changes in aerobic fitness (AF). Twenty Wistar rats performed: LACmintest3 (1): induction of hyperlactacidemia and incremental phase (4%, 5% and 6.5% of bw); Constant loads tests on (2) and above (3) the LMI. Half of the animals were subjected to training with the individual LMI and the tests were performed again. The mean exercise load in LACmintest3 was 5.04 ± 0.13% bw at 5.08 ± 0.55 mmol L-1 blood lactate minimum (BLM). There was a stabilize and disproportionate increase of blood lactate in tests 2 and 3, respectively. After the training period, the mean BLM was lower in the trained animals. The LACmintest3 seems to be a good indicator of LMI and responsive to changes in AF in rats subjected to swim training.

O objetivo deste estudo foi determinar a intensidade no lactato mínimo (ILM) pelo LACminteste usando três estágios incrementais (LACminteste3) e avaliar sua sensibilidade às alterações do condicionamento aeróbio (CA). Vinte ratos realizaram: LACminteste3 (1): indução da hiperlactacidemia e fase incremental (4%, 5% e 6,5% do pc); Testes de cargas constantes equivalentes (2) e acima (3) da ILM. Metade dos animais foi submetida ao treinamento físico na ILM individual e os testes foram efetuados novamente. A sobrecarga média no LACmintest3foi 5,04 ± 0,13% pc à 5,08 ± 0,55 mmol L-1 de lactato sanguíneo mínimo (LSM). Houve estabilização e aumento desproporcional do lactato sanguíneo nos testes 2 e 3, respectivamente. Após o período de treinamento, o LSM médio foi menor no grupo treinado. O LACminteste3 parece ser um bom indicador da ILM e responsivo às mudanças no CA em ratos treinados por natação.

Determinar la intensidad del lactato mínimo (ILM) por LACmintest incremental mediante tres etapas graduales (LACmintest3) y evaluar su sensibilidad a los cambios en condiciones aerobias (CA). Veinte ratas realizaron: LACmintest3 (1): inducción de hiperlactacidemia y fase incremental (4 %, 5% y 6,5 % de pc); pruebas de cargas constantes equivalente (2) y arriba (3) de la ILM. Mitad de los animales fueron sometidos a entrenamiento físico con la persona carga equivalente a la ILM y las pruebas se realizaron nuevamente. La carga media en LACmintest3fue 5,04 ± 0,13 % pc a 5,08 ± 0,55 mmol L-1 de lactato mínimo en la sangre (LMS). Se observó una estabilización y desproporcionado aumento de lactato sanguíneo en las pruebas 2 y 3, respectivamente. Después del período de entrenamiento físico, la media fue menor en el grupo entrenado. LACmintest3resultó ser un buen indicador de la ILM y sensible a los cambios que se producen en el CA en ratas entrenadas por nadar.

Association between anaerobic components of the maximal accumulated oxygen deficit and 30-second Wingate test

The purpose of this study was to analyze the relationship between the anaerobic components of the maximal accumulated oxygen deficit (MAOD) and of the 30-second Wingate anaerobic test (30-WAnT). Nine male physical education students performed: a) a maximal incremental exercise test; b) a supramaximal constant workload test to determine the anaerobic components of the MAOD; and c) a 30-WAnT to measure the peak power (PP) and mean power (MP). The fast component of the excess post-exercise oxygen consumption and blood lactate accumulation were measured after the supramaximal constant workload test in order to determine the contributions made by alactic (ALMET) and lactic (LAMET) metabolism. Significant correlations were found between PP and ALMET (r=0.71; P=0.033) and between MP and LAMET (r=0.72; P=0.030). The study results suggested that the anaerobic components of the MAOD and of the 30-WAnT are similarly applicable in the assessment of ALMET and LAMET during high-intensity exercise.

Effects of four weeks of repeated sprint training on physiological indices in futsal players / Efeito de quatro semanas de treinamento de sprints repetidos sobre índices fisiológicos em atletas de futsal

The aim of this study was to investigate the effects of short repeated-sprint ability (RSA) training on the neuromuscular and physiological indices in U17 futsal players during the competitive period. Fourteen players were divided into two groups: intervention group (n = 8) and control group (n = 6). Both groups performed a repeated maximal sprint test (40-m MST), intermittent shuttle-running test (Carminatti's test) and vertical jumps before and after the training period. The intervention group was submitted to an additional four-week repeated sprints program, twice a week, while the control group maintained their normal training routine. There was no significant interaction between time and groups for all variables analysed (p > 0.05). However, a significant main effect was observed for time (p < 0.01) indicating an increase on speed at heart rate deflection point (VHRDP) and the continuous jump performance while the peak lactate (40m-LACpeak) and sprint decrement decreased after training, in both groups. Still, based on effect sizes (ES) the greater changes with practical relevance were verified for intervention group in important variables such as peak velocity (ES = 0,71), VHRDP (ES = 0,83) and 40m-LACpeak (ES = 1,00). This study showed that RSA-based and normal training routine are equally effective in producing changes in the analysed variables during a short period of intervention. However, the effect size suggests that four weeks of RSA training would be a minimum time that could induce the first changes of futsal player's physical fitness.

O objetivo deste estudo foi investigar os efeitos do treinamento de sprints repetidos (RSA) nos índices fisiológicos e neuromusculares em atletas de futsal sub17 durante a temporada competitiva. Quatorze jogadores foram divididos em dois grupos: grupo intervenção (n = 8) e controle (n = 6). Ambos os grupos desempenharam testes de sprints máximos repetidos (40-m MST), teste de corrida intermitente (teste de Carminatti) e saltos verticais antes e depois do período de treinamento. O grupo intervenção foi submetido a um programa adicional de quatro semanas de RSA, duas vezes por semana, enquanto o grupo controle manteve a rotina normal de treinos. Não houve interação significante entre tempo e grupo para todas as variáveis analisadas (p > 0.05). Entretanto, um efeito principal significante foi observado para o tempo (p < 0.01), indicando um aumento na velocidade do ponto de deflexão da frequência cárdica (VHRDP) e na performance do salto contínuo, bem como, diminuição no pico de lactato (40m-LACpeak) e no decréscimo dos sprints após o treinamento em ambos os grupos. Ainda, baseado no effect size (ES), maiores mudanças com relevância prática foram verificadas para o grupo intervenção em importantes variáveis tais como: pico de velocidade (ES = 0,71) VHRDP (ES = 0,83) e 40m-LACpeak (ES = 1,00). Este estudo demonstrou que o treinamento de RSA e a rotina normal de treinos são igualmente efetivos em produzir mudanças nas variáveis analisadas durante um curto período de intervenção. Porém, o effect size sugere que quatro semanas de treinamento de RSA pode ser um tempo mínimo para que ocorram as primeiras alterações no desempenho físico de atletas de futsal.

Differing effects of aquatic movement in either deep or shallow water on the physiological responses among middle-aged, female and recreational synchronized swimmers / 体力科学

This study examined the physiological response to different water depths in recreational synchronized swimming. Nine middle-aged, female, recreational swimmers carried out the same team free routines in deep water (deep-water synchronized swimming: DWS) and shallow water (shallow-water synchronized swimming: SWS). Heart rate (HR) was measured continuously during each performance, combined with estimation of metabolic equivalent (MET) values using individual linear regression equations of HR-oxygen uptake. These equations were created using the results of 12 water activities. Blood lactate concentration and systolic blood pressure were measured at the 1/3 and 2/3 stages and immediately after each performance period. HR and estimated METs during DWS (mean±SD, 152.9±7.5 beats·min^-1 and 7.3±1.2) were significantly higher than those measured during SWS (131.8±11.3 beats·min^-1 and 5.7±0.8). Blood lactate concentration and systolic blood pressure measured immediately after DWS were significantly higher than those measured after SWS. With DWS, blood lactate concentration at the 2/3 stage and immediately after the performance were significantly higher than those measured at the 1/3 stage, whereas in SWS no significant difference was found in these values at any time period. In conclusion, the exercise intensity of DWS was high and SWS moderate. The predominant sources of energy may be phosphocreatine stores and aerobic metabolism during these performances. It is possible that glycolysis may also play an important role in energy requirements during the 2/3 stage and immediately after a DWS performance.